KENTUCKY PHARMACY #1, LLC
NPI: 1063897015
· SHELBYVILLE, KY 40065
· Community/Retail Pharmacy
· NPI assigned 07/20/2015
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | UNDERWOOD, JASON (SOLE MEMBER) |
| NPI Enumeration Date | 07/20/2015 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
33 |
$0.00 |
| 2022 |
12 |
$0.00 |
| 2023 |
16 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0064A |
|
31 |
31 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
14 |
13 |
$0.00 |
| 0134A |
|
16 |
16 |
$0.00 |