NPI: 1700115086 · OMAHA, NE 68138 · 251F00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 47 | $63K |
| 2019 | 189 | $189K |
| 2020 | 285 | $2K |
| 2021 | 155 | $3K |
| 2022 | 92 | $2K |
| 2023 | 18 | $27K |
| 2024 | 466 | $835K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| J2315 | Naltrexone, depot form | 297 | 276 | $445K |
| S0013 | Esketamine, nasal spray | 169 | 85 | $350K |
| 90378 | 236 | 60 | $252K | |
| J0741 | Inj, cabote rilpivir 2mg 3mg | 18 | 12 | $67K |
| A4221 | Supp non-insulin inf cath/wk | 399 | 374 | $7K |
| S9562 | Ht inj palivizumab/ab diem | 91 | 81 | $0.00 |
| J0171 | Adrenalin epinephrine inject | 42 | 38 | $0.00 |