SAINT-MARK ENTERPRISES 1883 LLC

NPI: 1710124037 · MAUMELLE, AR 72113 · Community/Retail Pharmacy · NPI assigned 01/08/2009

$3K

Total Medicaid Paid

361

Total Claims

206

Beneficiaries

Codes Billed

2021-03

First Month

2021-06

Last Month

Provider Details

Authorized Official	MILLER, MARK (OWNER)
NPI Enumeration Date	01/08/2009

Other providers sharing the same authorized official: MILLER, MARK

Provider	City	State	Total Paid
TOE-TAL FAMILY FOOTCARE ASSOCIATES	VISTA	CA	$693K
CHRISTOPHER UNIT SCH DIST 99	CHRISTOPHER	IL	$165K
SAINT-MARK ENTERPRISES 1788 LLC	DEER PARK	WA	$65K
NEIGHBORHOOD SLEEP PHYSICIANS	OLNEY	MD	$53K
TREASURE VALLEY EYE CENTER P A	MERIDIAN	ID	$30K
HIGH COUNTRY OPTICAL, INC	DURANGO	CO	$29K
SAINT-MARK ENTERPRISES 1798 LLC	TOMAH	WI	$19K
MARK P. MILLER, M.D.,INC.	ANAHEIM	CA	$6K
SAINT-MARK ENTERPRISES 1906 LLC	CONWAY	AR	$1K
MILLER AND MILLER, OD LTD	LAS VEGAS	NV	$206.58

Year	Claims	Total Paid
2021	361	$3K

Code	Claims	Beneficiaries	Total Paid
0011A	99	59	$896.94
0001A	55	25	$792.00
0002A	39	18	$552.00
0012A	37	22	$280.00
91301	65	39	$0.01
91300	66	43	$0.00