NPI: 1053378513 · EL DORADO, KS 67042 · Pharmacy · NPI assigned 04/28/2006
| Authorized Official | BELLESINE, MICHAEL (OWNER/PHARMACIST IN CHARGE) |
| NPI Enumeration Date | 04/28/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 50 | $49.91 |
| 2019 | 60 | $0.00 |
| 2021 | 206 | $675.20 |
| 2023 | 12 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 0001A | 31 | 27 | $320.00 | |
| 0011A | 69 | 61 | $155.20 | |
| 0012A | 53 | 50 | $80.00 | |
| 0002A | 15 | 14 | $80.00 | |
| A4253 | Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips | 34 | 24 | $49.91 |
| 0004A | 38 | 38 | $40.00 | |
| G0008 | Administration of influenza virus vaccine | 57 | 57 | $0.00 |
| 90686 | 19 | 19 | $0.00 | |
| 91322 | 12 | 12 | $0.00 |