NPI: 1083166680 · PALMYRA, ME 04965 · 332B00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 246 | $49K |
| 2019 | 540 | $81K |
| 2020 | 753 | $164K |
| 2021 | 843 | $207K |
| 2022 | 439 | $61K |
| 2023 | 878 | $117K |
| 2024 | 260 | $45K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| K0108 | W/c component-accessory nos | 1,014 | 772 | $252K |
| E1161 | Manual adult wc w tiltinspac | 221 | 145 | $220K |
| E1028 | W/c manual swingaway | 1,381 | 929 | $172K |
| K0739 | Repair/svc dme non-oxygen eq | 751 | 595 | $36K |
| E0955 | Cushioned headrest | 246 | 190 | $22K |
| E0973 | W/ch access det adj armrest | 124 | 100 | $15K |
| S9999 | Sales tax | 156 | 150 | $4K |
| E0971 | Wheelchair anti-tipping devi | 30 | 27 | $2K |
| K0040 | Adjustable angle footplate | 12 | 12 | $1K |
| E2213 | Pneumatic prop tire insert | 12 | 12 | $650.64 |
| E2211 | Pneumatic propulsion tire | 12 | 12 | $369.36 |