PINK RIBBON BOUTIQUE LLC
NPI: 1902091051
· SMYRNA, DE 19977
· Durable Medical Equipment & Medical Supplies
· NPI assigned 09/12/2007
$475.82
Total Medicaid Paid
Provider Details
| Authorized Official | HADLEY, THERESA (OWNER/MEMBER) |
| NPI Enumeration Date | 09/12/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
18 |
$21.18 |
| 2019 |
51 |
$454.64 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L8000 |
Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type |
69 |
40 |
$475.82 |