NPI: 1649723263 · GRAND RAPIDS, MI 49503 · Durable Medical Equipment & Medical Supplies · NPI assigned 08/01/2016
Authorized official PONCE, JENNIFER controls 20+ related entities in our dataset. Read more
| Authorized Official | PONCE, JENNIFER (MANAGER) |
| Parent Organization | WALGREENS BOOTS ALLIANCE INC |
| NPI Enumeration Date | 08/01/2016 |
Other providers sharing the same authorized official: PONCE, JENNIFER
| Provider | City | State | Total Paid |
|---|---|---|---|
| CYSTIC FIBROSIS SERVICES LLC | FRISCO | TX | $205K |
| WALGREEN CO | SHELTON | CT | $31K |
| WALGREEN CO | WHITEVILLE | NC | $26K |
| WALGREEN CO | HAMDEN | CT | $22K |
| WALGREEN CO | LAKEWOOD | CO | $20K |
| WALGREEN CO | DE PERE | WI | $17K |
| WALGREEN CO | KINSTON | NC | $16K |
| DUANE READE | NEW YORK | NY | $7K |
| WALGREEN CO | VIROQUA | WI | $6K |
| WALGREEN CO | GUILDERLAND | NY | $6K |
| WALGREEN CO | APEX | NC | $5K |
| WALGREEN CO | WILMINGTON | NC | $4K |
| WALGREEN CO | GEORGETOWN | SC | $720.00 |
| WALGREEN CO | BRYANT | AR | $290.52 |
| WALGREEN CO | HESPERIA | CA | $281.52 |
| WALGREEN CO | SHORELINE | WA | $240.00 |
| WALGREEN CO | COVINGTON | LA | $74.79 |
| WALGREEN CO | GLENVIEW | IL | $2.20 |
| WALGREEN CO | POUGHKEEPSIE | NY | $0.00 |
| WALGREEN CO | MITCHELL | SD | $0.00 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 64 | $355.20 |
| 2022 | 16 | $3K |
| 2023 | 297 | $66K |
| 2024 | 212 | $56K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A9274 | External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories | 456 | 433 | $116K |
| A4239 | Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | 53 | 48 | $6K |
| K0553 | Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | 16 | 14 | $3K |
| Q0511 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period | 38 | 38 | $249.60 |
| Q0512 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period | 26 | 24 | $105.60 |