MOON'S DRUG STORE, INC.
NPI: 1043236524
· WESTMINSTER, SC 29693
· 332B00000X
$388K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,027 |
$51K |
| 2019 |
1,723 |
$46K |
| 2020 |
2,034 |
$57K |
| 2021 |
2,231 |
$66K |
| 2022 |
2,452 |
$70K |
| 2023 |
2,058 |
$55K |
| 2024 |
1,649 |
$44K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| X1939 |
|
1,965 |
1,961 |
$130K |
| A4554 |
Disposable underpads |
2,506 |
2,401 |
$79K |
| T4526 |
Adult size pull-on med |
1,165 |
1,154 |
$53K |
| T5999 |
Supply, nos |
6,059 |
5,434 |
$41K |
| T4535 |
Disposable liner/shield/pad |
1,295 |
1,154 |
$37K |
| E1390 |
Oxygen concentrator |
456 |
398 |
$26K |
| E0260 |
Hosp bed semi-electr w/ matt |
192 |
163 |
$9K |
| K0001 |
Standard wheelchair |
323 |
272 |
$8K |
| T4527 |
Adult size pull-on lg |
64 |
53 |
$3K |
| E0570 |
Nebulizer with compression |
122 |
115 |
$2K |
| E0431 |
Portable gaseous 02 |
27 |
24 |
$376.66 |