467 B
467 B
| 1 | pt id | device_type | service date | quantity | payer | component |
|---|---|---|---|---|---|---|
| 2 | PT-1201 | op5 | 11/15/2024 | 6 | Aetna Commercial | pod |
| 3 | PT-1202 | op5 | 12/28/2024 | 2 | Aetna Commercial | pod |
| 4 | PT-1203 | OmniPod 5 | 12/25/2024 | 9 | Aetna Commercial | pod |
| 5 | PT-1204 | OmniPod 5 | 12/30/2024 | 1 | Aetna Commercial | pod |
| 6 | PT-1205 | OmniPod 5 | 01/07/2025 | 2 | Aetna Commercial | pod |
| 7 | PT-1206 | Omnipod 5 | 10/28/2024 | 1 | Aetna Commercial | pod |
| 8 | PT-1207 | Omnipod 5 | 11/05/2024 | 6 | Aetna Commercial | pod |
| 9 | PT-1208 | Omnipod | 11/29/2024 | 6 | Aetna Commercial | pod |