NPI: 1255652210 · DE WITT, IA 52742 · 332B00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 46 | $566.82 |
| 2020 | 54 | $922.12 |
| 2021 | 360 | $5K |
| 2022 | 123 | $822.37 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 0011A | 45 | 44 | $2K | |
| A4253 | Blood glucose/reagent strips | 100 | 72 | $1K |
| 90686 | 77 | 77 | $1K | |
| 0012A | 45 | 44 | $1K | |
| 0002A | 16 | 16 | $560.00 | |
| 0001A | 14 | 13 | $480.00 | |
| 0013A | 12 | 12 | $320.00 | |
| 90471 | 71 | 71 | $137.43 | |
| M0201 | Pne flu hepb cov home admin | 15 | 15 | $33.15 |
| 91300 | 63 | 60 | $0.00 | |
| 0124A | 20 | 20 | $0.00 | |
| 91301 | 93 | 92 | $0.00 | |
| G0008 | Admin influenza virus vac | 12 | 12 | $0.00 |