DYER STATION PHARMACY, LLC
NPI: 1376526517
· DYER, TN 38330
· Durable Medical Equipment & Medical Supplies
· NPI assigned 11/22/2005
$474.20
Total Medicaid Paid
Provider Details
| Authorized Official | HOLYFIELD, DEREK (MANAGING PARTNER) |
| NPI Enumeration Date | 11/22/2005 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
186 |
$231.90 |
| 2019 |
139 |
$77.37 |
| 2020 |
103 |
$33.49 |
| 2021 |
59 |
$114.33 |
| 2022 |
12 |
$17.11 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
499 |
477 |
$474.20 |