RT FAMILY DISCOUNT PHARMACY INC.
NPI: 1316029119
· PONCA CITY, OK 74601
· Durable Medical Equipment & Medical Supplies
· NPI assigned 10/20/2006
$53.60
Total Medicaid Paid
Provider Details
| Authorized Official | JONES, DERRICK (PHARMACIST) |
| NPI Enumeration Date | 10/20/2006 |
Related Entities
Other providers sharing the same authorized official: JONES, DERRICK
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
25 |
$53.60 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
25 |
24 |
$53.60 |