MITCHELLS PARK STREET PHARMACY INC
NPI: 1487640579
· CALICO ROCK, AR 72519
· Pharmacy
· NPI assigned 09/23/2005
Provider Details
| Authorized Official | MITCHELL, SARAH (PRESIDENT) |
| NPI Enumeration Date | 09/23/2005 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
17 |
$0.00 |
| 2021 |
408 |
$2K |
| 2022 |
57 |
$0.00 |
| 2023 |
81 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0012A |
|
116 |
114 |
$605.17 |
| 0011A |
|
139 |
129 |
$587.77 |
| 0001A |
|
14 |
13 |
$560.00 |
| 0013A |
|
78 |
78 |
$360.00 |
| 91300 |
|
20 |
13 |
$0.20 |
| 91301 |
|
23 |
14 |
$0.16 |
| 90480 |
|
20 |
20 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
65 |
65 |
$0.00 |
| 0064A |
|
13 |
13 |
$0.00 |
| 90662 |
|
55 |
55 |
$0.00 |
| 91322 |
|
20 |
20 |
$0.00 |