GUARDIAN PHARMACY OF GRAND ISLAND, LLC
NPI: 1386363877
· GRAND ISLAND, NE 68803
· 332B00000X
$796.48
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
296 |
$757.61 |
| 2024 |
364 |
$38.87 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
37 |
26 |
$475.36 |
| T4526 |
Adult size pull-on med |
16 |
12 |
$247.10 |
| A4253 |
Blood glucose/reagent strips |
28 |
24 |
$38.87 |
| 90694 |
|
35 |
35 |
$27.72 |
| 90686 |
|
17 |
17 |
$7.43 |
| B4150 |
Ef complet w/intact nutrient |
191 |
130 |
$0.00 |
| 90480 |
|
62 |
62 |
$0.00 |
| G0008 |
Admin influenza virus vac |
67 |
67 |
$0.00 |
| T4528 |
Adult size pull-on xl |
145 |
116 |
$0.00 |
| 91322 |
|
62 |
62 |
$0.00 |