PUBLIX NORTH CAROLINA LP
NPI: 1174994925
· CONCORD, NC 28027
· Pharmacy
· NPI assigned 10/19/2015
$645.60
Total Medicaid Paid
Provider Details
| Authorized Official | RUSK, DAIN (VP PHARMACY) |
| NPI Enumeration Date | 10/19/2015 |
Related Entities
Other providers sharing the same authorized official: RUSK, DAIN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
32 |
$645.60 |
| 2021 |
14 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90674 |
|
16 |
16 |
$432.80 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16 |
16 |
$212.80 |
| 91301 |
|
14 |
14 |
$0.00 |