NPI: 1992731160 · DAVENPORT, IA 52802 · 332B00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 12 | $0.00 |
| 2019 | 397 | $6K |
| 2020 | 386 | $7K |
| 2021 | 986 | $18K |
| 2022 | 474 | $9K |
| 2023 | 395 | $11K |
| 2024 | 138 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A4253 | Blood glucose/reagent strips | 1,700 | 1,523 | $32K |
| 0001A | 201 | 201 | $6K | |
| K1034 | Covid test self-admn/collect | 97 | 96 | $6K |
| 0002A | 162 | 162 | $6K | |
| A4239 | Non-adju cgm supply allow | 13 | 13 | $1K |
| 90686 | 18 | 18 | $605.70 | |
| 0124A | 18 | 18 | $600.00 | |
| 0003A | 13 | 13 | $480.00 | |
| 0004A | 14 | 13 | $440.00 | |
| A4259 | Lancets per box | 233 | 221 | $396.59 |
| A4215 | Sterile needle | 12 | 12 | $178.00 |
| 90471 | 30 | 30 | $147.61 | |
| 91300 | 247 | 225 | $0.00 | |
| 91312 | 18 | 18 | $0.00 | |
| G0008 | Admin influenza virus vac | 12 | 12 | $0.00 |