LITTLEFIELD PRESCRIPTION SHOP LLC
NPI: 1093801607
· LITTLEFIELD, TX 79339
· Long Term Care Pharmacy
· NPI assigned 10/04/2006
$120.90
Total Medicaid Paid
Provider Details
| Authorized Official | PRATT, MICAH (OWNER) |
| NPI Enumeration Date | 10/04/2006 |
Related Entities
Other providers sharing the same authorized official: PRATT, MICAH
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
24 |
$120.90 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4335 |
Incontinence supply; miscellaneous |
12 |
12 |
$66.00 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
12 |
12 |
$54.90 |