NPI: 1336175975 · COUNCIL BLUFFS, IA 51503 · 332B00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 30 | $973.97 |
| 2020 | 122 | $4K |
| 2021 | 1,165 | $26K |
| 2022 | 319 | $15K |
| 2023 | 249 | $10K |
| 2024 | 102 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A4253 | Blood glucose/reagent strips | 673 | 651 | $17K |
| 0002A | 256 | 255 | $10K | |
| K0553 | Ther cgm supply allowance | 84 | 79 | $9K |
| 0001A | 271 | 271 | $9K | |
| A4239 | Non-adju cgm supply allow | 74 | 72 | $7K |
| 0004A | 66 | 64 | $2K | |
| 0071A | 19 | 19 | $760.00 | |
| 90686 | 37 | 37 | $612.50 | |
| 0124A | 13 | 13 | $480.00 | |
| 90471 | 39 | 39 | $188.33 | |
| A4215 | Sterile needle | 12 | 12 | $150.00 |
| A4259 | Lancets per box | 12 | 12 | $56.42 |
| 91307 | 19 | 19 | $0.00 | |
| 91300 | 399 | 359 | $0.00 | |
| 91312 | 13 | 13 | $0.00 |