NPI: 1821033051 · GREAT FALLS, MT 59405 · Pharmacy · NPI assigned 06/19/2006
| Authorized Official | WILHELM, DOUGLAS (MANAGING PARTNER) |
| NPI Enumeration Date | 06/19/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 188 | $30K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| B4160 | Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | 96 | 81 | $19K |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 92 | 76 | $11K |