NPI: 1407069297 · GRAND ISLAND, NE 68803 · 333600000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 139 | $6K |
| 2019 | 41 | $1K |
| 2020 | 225 | $10K |
| 2021 | 553 | $9K |
| 2022 | 824 | $20K |
| 2023 | 202 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T4527 | Adult size pull-on lg | 538 | 381 | $23K |
| B4150 | Ef complet w/intact nutrient | 260 | 172 | $12K |
| T4528 | Adult size pull-on xl | 222 | 143 | $8K |
| T4526 | Adult size pull-on med | 105 | 66 | $5K |
| A4253 | Blood glucose/reagent strips | 397 | 335 | $1K |
| A4259 | Lancets per box | 26 | 26 | $3.72 |
| G0008 | Admin influenza virus vac | 142 | 142 | $2.80 |
| 0004A | 14 | 14 | $0.00 | |
| 0124A | 36 | 36 | $0.00 | |
| 90694 | 69 | 69 | $0.00 | |
| 0064A | 89 | 89 | $0.00 | |
| 0011A | 24 | 24 | $0.00 | |
| 0012A | 17 | 17 | $0.00 | |
| 90674 | 25 | 25 | $0.00 | |
| 90686 | 20 | 20 | $0.00 |