NPI: 1619306214 · CHUBBUCK, ID 83202 · Long Term Care Pharmacy · NPI assigned 11/04/2013
| Authorized Official | BUFFAT, BLAKE (DIRECTOR OF PHARMACY) |
| NPI Enumeration Date | 11/04/2013 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 346 | $18K |
| 2019 | 48 | $4K |
| Code | Description | Claims | Bene. Records | Total Paid |
|---|---|---|---|---|
| B4150 | Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | 249 | 211 | $22K |
| 90686 | 72 | 66 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 73 | 67 | $0.00 |