HARTSVILLE PHARMACY LLC.
NPI: 1457543084
· HARTSVILLE, TN 37074
· Community/Retail Pharmacy
· NPI assigned 08/17/2007
$50.94
Total Medicaid Paid
Provider Details
| Authorized Official | BROYLES, AMY (OWNER/PHARMACIST) |
| NPI Enumeration Date | 08/17/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
27 |
$48.04 |
| 2021 |
13 |
$2.90 |
| 2022 |
12 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
40 |
39 |
$50.94 |
| 90674 |
|
12 |
12 |
$0.00 |