GOODYKOONTZ DRUG STORES INC
NPI: 1417054255
· BLUEFIELD, WV 24701
· Pharmacy
· NPI assigned 09/20/2006
$565.52
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
26 |
$325.95 |
| 2019 |
37 |
$139.75 |
| 2020 |
38 |
$99.82 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0008 |
Administration of influenza virus vaccine |
24 |
24 |
$291.00 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
77 |
74 |
$274.52 |