WEST SIDE PHARMACY INCORPORATED
NPI: 1013922541
· BENTON, AR 72015
· Medical Specialty Clinic/Center
· NPI assigned 07/31/2006
Provider Details
| Authorized Official | HALEY, JAMES (PHARMACIST IN CHARGE) |
| NPI Enumeration Date | 07/31/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
2,546 |
$28K |
| 2022 |
227 |
$720.00 |
| 2023 |
120 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0002A |
|
729 |
715 |
$15K |
| 0001A |
|
797 |
781 |
$11K |
| 0004A |
|
78 |
75 |
$1K |
| 0003A |
|
38 |
37 |
$200.00 |
| G0008 |
Administration of influenza virus vaccine |
26 |
23 |
$77.25 |
| 91300 |
|
897 |
772 |
$4.72 |
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
328 |
321 |
$0.00 |