NPI: 1083640114 · IOWA CITY, IA 52240 · 3336L0003X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 336 | $6K |
| 2020 | 337 | $8K |
| 2021 | 2,282 | $48K |
| 2022 | 749 | $18K |
| 2023 | 403 | $25K |
| 2024 | 119 | $5K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A4253 | Blood glucose/reagent strips | 1,251 | 1,150 | $33K |
| 0002A | 456 | 455 | $17K | |
| 0001A | 477 | 476 | $17K | |
| A4239 | Non-adju cgm supply allow | 117 | 114 | $14K |
| K1034 | Covid test self-admn/collect | 227 | 224 | $9K |
| 0004A | 138 | 135 | $5K | |
| 91320 | 30 | 30 | $4K | |
| 0064A | 73 | 72 | $3K | |
| 0124A | 55 | 55 | $2K | |
| 90480 | 39 | 39 | $1K | |
| 0031A | 32 | 32 | $1K | |
| 90686 | 92 | 92 | $1K | |
| 0072A | 15 | 15 | $600.00 | |
| 0071A | 14 | 14 | $560.00 | |
| S8490 | 100 insulin syringes | 33 | 24 | $435.03 |
| 90471 | 75 | 75 | $381.75 | |
| A4215 | Sterile needle | 12 | 12 | $242.00 |
| A4259 | Lancets per box | 89 | 88 | $223.99 |
| 91305 | 13 | 13 | $0.00 | |
| 91301 | 81 | 81 | $0.00 | |
| 91307 | 56 | 54 | $0.00 | |
| 91300 | 812 | 745 | $0.00 | |
| 91312 | 39 | 39 | $0.00 |