NPI: 1104954916 · LEHIGHTON, PA 18235 · Long Term Care Pharmacy · NPI assigned 03/01/2007
| Authorized Official | GLENNON, MICHAEL (VP) |
| NPI Enumeration Date | 03/01/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 40 | $1K |
| 2019 | 57 | $3K |
| Code | Description | Claims | Bene. Records | Total Paid |
|---|---|---|---|---|
| B4150 | Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | 57 | 36 | $3K |
| T4527 | Adult sized disposable incontinence product, protective underwear/pull-on, large size, each | 21 | 13 | $933.12 |
| B4100 | Food thickener, administered orally, per ounce | 19 | 12 | $556.30 |