MTM PHARMA INC
NPI: 1659797421
· SANTA ANA, CA 92703
· Pharmacy
· NPI assigned 03/17/2014
Deactivated NPI
· This NPI was deactivated on 09/01/2021. Reactivated 09/14/2021.
Provider Details
| Authorized Official | LE, DENISE (PRESIDENT/PIC) |
| NPI Enumeration Date | 03/17/2014 |
Related Entities
Other providers sharing the same authorized official: LE, DENISE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
421 |
$1K |
| 2019 |
149 |
$588.40 |
| 2020 |
28 |
$229.65 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
357 |
334 |
$2K |
| A4259 |
Lancets, per box of 100 |
241 |
231 |
$131.35 |