NPI: 1235560020 · SIOUX CITY, IA 51104 · 332B00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 204 | $4K |
| 2020 | 649 | $12K |
| 2021 | 932 | $16K |
| 2022 | 442 | $9K |
| 2023 | 216 | $5K |
| 2024 | 28 | $705.88 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A4253 | Blood glucose/reagent strips | 1,704 | 1,390 | $39K |
| 0011A | 79 | 79 | $2K | |
| 0012A | 51 | 49 | $2K | |
| 0001A | 55 | 55 | $1K | |
| A4259 | Lancets per box | 328 | 310 | $787.12 |
| T5999 | Supply, nos | 69 | 65 | $691.62 |
| A4215 | Sterile needle | 30 | 25 | $616.00 |
| 0002A | 14 | 14 | $320.00 | |
| 91301 | 93 | 90 | $0.00 | |
| 91300 | 48 | 47 | $0.00 |