SOUTH SIDE DRUG CO INC
NPI: 1649312737
· SPRINGFIELD, TN 37172
· Community/Retail Pharmacy
· NPI assigned 02/13/2007
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | SLOAN, DON (PHARMACIST) |
| NPI Enumeration Date | 02/13/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
18 |
$0.00 |
| 2020 |
18 |
$0.00 |
| 2021 |
14 |
$0.00 |
| 2023 |
32 |
$0.00 |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 90662 |
|
20 |
20 |
$0.00 |
| 90630 |
|
18 |
18 |
$0.00 |
| J3490 |
Unclassified drugs |
32 |
32 |
$0.00 |
| 90686 |
|
12 |
12 |
$0.00 |