NPI: 1902990633 · LARAMIE, WY 82070 · Pharmacist · NPI assigned 10/03/2006
| Authorized Official | SCOZZAFAVA, JENNA (PHARMACIST-IN-CHARGE) |
| NPI Enumeration Date | 10/03/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 39 | $7K |
| 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 | 39 | 26 | $7K |