WHITE DRUG ENTERPRISES INC
NPI: 1518056118
· CLEAR LAKE, IA 50428
· 291U00000X
$682.19
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
63 |
$0.00 |
| 2021 |
37 |
$600.00 |
| 2022 |
64 |
$82.19 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0013A |
|
20 |
18 |
$600.00 |
| 90686 |
|
27 |
27 |
$51.69 |
| 90471 |
|
37 |
37 |
$30.50 |
| 91301 |
|
17 |
17 |
$0.00 |
| 90688 |
|
14 |
14 |
$0.00 |
| G0008 |
Admin influenza virus vac |
36 |
36 |
$0.00 |
| 90682 |
|
13 |
13 |
$0.00 |