NPI: 1700828522 · AIEA, HI 96701 · 332B00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 16 | $200.96 |
| 2019 | 34 | $0.00 |
| 2020 | 94 | $1K |
| 2021 | 1,247 | $38K |
| 2022 | 299 | $7K |
| 2023 | 167 | $5K |
| 2024 | 217 | $7K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 0012A | 465 | 465 | $17K | |
| 0011A | 472 | 472 | $15K | |
| 90471 | 522 | 508 | $6K | |
| 0064A | 137 | 137 | $5K | |
| 91322 | 44 | 44 | $5K | |
| 90674 | 114 | 113 | $3K | |
| 90686 | 142 | 141 | $2K | |
| 90480 | 52 | 52 | $2K | |
| 0134A | 34 | 34 | $1K | |
| 90661 | 31 | 31 | $907.66 | |
| 90656 | 15 | 15 | $222.00 | |
| 90472 | 12 | 12 | $70.80 | |
| S9430 | Pharmacy comp/disp serv | 34 | 31 | $0.00 |