MY DR'S PHARMACY
NPI: 1629426648
· HERNDON, VA 20170
· Primary Care Clinic/Center
· NPI assigned 05/31/2016
$243.34
Total Medicaid Paid
Provider Details
| Authorized Official | MANNA, JAMIL (OWNER, PIC, AO) |
| NPI Enumeration Date | 05/31/2016 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
102 |
$231.67 |
| 2023 |
14 |
$11.67 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0001A |
|
13 |
13 |
$118.58 |
| 0011A |
|
31 |
31 |
$84.70 |
| 0012A |
|
58 |
58 |
$28.39 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
12 |
$11.67 |