ST. FRANCIS DISCOUNT PHARMACY LLC
NPI: 1023692449
· FORREST CITY, AR 72335
· Community/Retail Pharmacy
· NPI assigned 05/11/2021
$166.35
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: KASSISSIEH, RANDY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
70 |
$166.35 |
| 2022 |
61 |
$0.00 |
| 2024 |
70 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0064A |
|
26 |
24 |
$120.00 |
| G0008 |
Administration of influenza virus vaccine |
63 |
58 |
$46.35 |
| G0009 |
Administration of pneumococcal vaccine |
14 |
14 |
$0.00 |
| 90480 |
|
14 |
13 |
$0.00 |
| 90677 |
|
14 |
14 |
$0.00 |
| 0134A |
|
17 |
17 |
$0.00 |
| 90694 |
|
17 |
17 |
$0.00 |
| 90662 |
|
22 |
22 |
$0.00 |
| 91322 |
|
14 |
13 |
$0.00 |