CLAYSVILLE PHARMACY LLC
NPI: 1134159536
· CLAYSVILLE, PA 15323
· Diabetes Educator Registered Nurse
· NPI assigned 07/03/2006
$275.00
Total Medicaid Paid
Provider Details
| Authorized Official | CUSHEY, ERICH (OWNER) |
| NPI Enumeration Date | 07/03/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
16 |
$143.00 |
| 2024 |
12 |
$132.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
28 |
28 |
$275.00 |