NPI: 1922164458 · KANKAKEE, IL 60901 · Home Infusion Therapy Pharmacy · NPI assigned 12/29/2006
| Authorized Official | DOUGLAS, BILL (CFO) |
| Parent Organization | RIVERSIDE MEDICAL CENTER |
| NPI Enumeration Date | 12/29/2006 |
Other providers sharing the same authorized official: DOUGLAS, BILL
| Provider | City | State | Total Paid |
|---|---|---|---|
| RIVERSIDE MEDICAL CENTER | KANKAKEE | IL | $3.72M |
| RIVERSIDE MEDICAL CENTER | KANKAKEE | IL | $1.59M |
| RIVERSIDE MEDICAL CENTER | PEOTONE | IL | $1.17M |
| RIVERSIDE MEDICAL CENTER | KANKAKEE | IL | $245K |
| RIVERSIDE MEDICAL CENTER | KANKAKEE | IL | $104K |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 18 | $528.96 |
| 2019 | 69 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| B4034 | Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 67 | 51 | $2K |
| B4152 | Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 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 | 20 | 12 | $2K |