NPI: 1790840122
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 19 | $217.52 |
| 2019 | 18 | $0.00 |
| 2020 | 69 | $968.20 |
| 2021 | 32 | $960.96 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 55 | 55 | $598.32 |
| 90686 | 33 | 33 | $587.40 | |
| 0012A | 15 | 15 | $480.48 | |
| 0011A | 17 | 17 | $480.48 | |
| S9430 | Pharmacy compounding and dispensing services | 18 | 14 | $0.00 |