JELLICO DRUG STORE INC
NPI: 1093753196
· JELLICO, TN 37762
· Parenteral & Enteral Nutrition Supplies (DME)
· NPI assigned 06/02/2006
$190.17
Total Medicaid Paid
Provider Details
| Authorized Official | BAIRD, JOHN (OWNER / PHARMACIST / PRESIDENT) |
| NPI Enumeration Date | 06/02/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
111 |
$172.63 |
| 2019 |
13 |
$17.54 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
112 |
106 |
$137.37 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
12 |
12 |
$52.80 |