NPI: 1689655243 · MOUNTAIN LAKE, MN 56159 · Durable Medical Equipment & Medical Supplies · NPI assigned 11/10/2005
| Authorized Official | WILLIS, LORI (ACQUISITIONS MANAGER) |
| NPI Enumeration Date | 11/10/2005 |
Other providers sharing the same authorized official: WILLIS, LORI
| Provider | City | State | Total Paid |
|---|---|---|---|
| NUDAK VENTURES, LLC | WATERLOO | IA | $331K |
| NUDAK VENTURES LLC | NEVADA | IA | $14K |
| PM ACQUISITION, LLC | IOWA CITY | IA | $8K |
| NUDAK VENTURES LLC | FAIRFIELD | IA | $6K |
| GREENFIELD PHARMACY LLC | GREENFIELD | IA | $4K |
| NUDAK VENTURES LLC | WEST UNION | IA | $3K |
| NUDAK VENTURES LLC | AMES | IA | $2K |
| NUDAK VENTURES LLC | ACKLEY | IA | $1K |
| NUDAK VENTURES, LLC | STORY CITY | IA | $672.00 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 48 | $732.41 |
| 2022 | 52 | $94.90 |
| 2023 | 40 | $104.60 |
| 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 | 21 | 13 | $732.41 |
| 90674 | 44 | 44 | $141.84 | |
| G0008 | Administration of influenza virus vaccine | 48 | 48 | $57.66 |
| 0013A | 15 | 15 | $0.00 | |
| 0011A | 12 | 12 | $0.00 |