NPI: 1225064405 · DAVENPORT, IA 52804 · 332B00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 16 | $0.00 |
| 2019 | 423 | $7K |
| 2020 | 463 | $11K |
| 2021 | 1,527 | $33K |
| 2022 | 1,000 | $33K |
| 2023 | 937 | $37K |
| 2024 | 601 | $9K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A4253 | Blood glucose/reagent strips | 2,003 | 1,833 | $46K |
| A4239 | Non-adju cgm supply allow | 134 | 129 | $20K |
| K1034 | Covid test self-admn/collect | 174 | 173 | $12K |
| K0553 | Ther cgm supply allowance | 75 | 68 | $12K |
| 0001A | 297 | 297 | $10K | |
| 0002A | 254 | 253 | $10K | |
| A4215 | Sterile needle | 452 | 425 | $7K |
| 91320 | 37 | 37 | $4K | |
| 90686 | 80 | 80 | $2K | |
| A4259 | Lancets per box | 660 | 625 | $2K |
| 0004A | 30 | 30 | $1K | |
| 0003A | 30 | 29 | $1K | |
| 90480 | 41 | 41 | $1K | |
| 0031A | 20 | 20 | $720.00 | |
| 90471 | 119 | 119 | $564.99 | |
| 0064A | 16 | 16 | $520.00 | |
| 0124A | 13 | 13 | $480.00 | |
| 0011A | 13 | 13 | $480.00 | |
| S8490 | 100 insulin syringes | 12 | 12 | $417.91 |
| 91300 | 434 | 410 | $0.00 | |
| 91312 | 13 | 13 | $0.00 | |
| 91301 | 44 | 44 | $0.00 | |
| G0008 | Admin influenza virus vac | 16 | 16 | $0.00 |