MOUTON PHARMACY INC
NPI: 1366439648
· RAYNE, LA 70578
· Durable Medical Equipment & Medical Supplies
· NPI assigned 10/03/2005
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | MOUTON, ANDREW (MANAGER/OWNER) |
| NPI Enumeration Date | 10/03/2005 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
26 |
$0.00 |
| 2020 |
12 |
$0.00 |
| 2021 |
12 |
$0.00 |
| 2022 |
14 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0008 |
Administration of influenza virus vaccine |
51 |
51 |
$0.00 |
| 90686 |
|
13 |
13 |
$0.00 |