NPI: 1891807780 · BRIDGETON, MO 63044 · 261QE0700X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 854 | $28K |
| 2020 | 1,926 | $29K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 90999 | 1,130 | 90 | $56K | |
| A4657 | Syringe w/wo needle | 1,014 | 49 | $682.89 |
| 85018 | 161 | 49 | $1.89 | |
| 84520 | 94 | 48 | $0.00 | |
| 83970 | 24 | 12 | $0.00 | |
| 84155 | 52 | 36 | $0.00 | |
| 82108 | 16 | 12 | $0.00 | |
| 83540 | 27 | 24 | $0.00 | |
| 84466 | 15 | 12 | $0.00 | |
| 87340 | 70 | 48 | $0.00 | |
| 84075 | 39 | 24 | $0.00 | |
| 85025 | 44 | 36 | $0.00 | |
| 82728 | 39 | 24 | $0.00 | |
| 86704 | 16 | 12 | $0.00 | |
| 83735 | 39 | 24 | $0.00 |