NPI: 1225726326 · GREAT FALLS, MT 59405 · 332B00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 1,789 | $126K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A4927 | Non-sterile gloves | 627 | 404 | $42K |
| T4528 | Adult size pull-on xl | 202 | 155 | $31K |
| T4526 | Adult size pull-on med | 208 | 167 | $25K |
| T4535 | Disposable liner/shield/pad | 149 | 114 | $13K |
| T4537 | Reusable underpad bed size | 271 | 217 | $11K |
| T4541 | Large disposable underpad | 59 | 46 | $2K |
| L0621 | Sio flex pelvic/sacr pre ots | 30 | 14 | $1K |
| T2028 | Special supply, nos waiver | 75 | 50 | $1K |
| A4520 | Incontinence garment anytype | 156 | 149 | $0.00 |
| A4553 | Nondisp underpads, all sizes | 12 | 12 | $0.00 |