NPI: 1326075011 · FORT DODGE, IA 50501 · 332B00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 243 | $104.28 |
| 2019 | 244 | $4K |
| 2020 | 302 | $8K |
| 2021 | 2,337 | $55K |
| 2022 | 1,017 | $28K |
| 2023 | 952 | $31K |
| 2024 | 612 | $10K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A4253 | Blood glucose/reagent strips | 1,990 | 1,863 | $42K |
| 0002A | 415 | 412 | $15K | |
| A4215 | Sterile needle | 810 | 778 | $14K |
| K0553 | Ther cgm supply allowance | 133 | 125 | $14K |
| 0001A | 418 | 418 | $14K | |
| A4239 | Non-adju cgm supply allow | 148 | 140 | $12K |
| 0004A | 121 | 120 | $4K | |
| K1034 | Covid test self-admn/collect | 60 | 60 | $4K |
| 91320 | 35 | 35 | $4K | |
| 0124A | 55 | 55 | $2K | |
| 90480 | 59 | 59 | $2K | |
| 90686 | 156 | 155 | $2K | |
| 0072A | 33 | 33 | $1K | |
| 0071A | 31 | 31 | $1K | |
| A9276 | Disposable sensor, cgm sys | 12 | 12 | $985.32 |
| 90471 | 131 | 131 | $554.81 | |
| 0054A | 12 | 12 | $480.00 | |
| 0064A | 14 | 14 | $440.00 | |
| A4259 | Lancets per box | 127 | 122 | $377.80 |
| 0011A | 19 | 19 | $237.16 | |
| 91307 | 74 | 70 | $0.00 | |
| 91305 | 37 | 35 | $0.00 | |
| G0008 | Admin influenza virus vac | 43 | 43 | $0.00 |
| 91300 | 700 | 634 | $0.00 | |
| 91312 | 51 | 51 | $0.00 | |
| 90662 | 23 | 23 | $0.00 |