EVANGELINE DRUG STORE INC
NPI: 1730277369
· VILLE PLATTE, LA 70586
· Community/Retail Pharmacy
· NPI assigned 10/10/2006
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | LEBAS, HARVEY (OWNER/PHARMACIST) |
| NPI Enumeration Date | 10/10/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
111 |
$0.00 |
| 2019 |
103 |
$0.00 |
| 2020 |
161 |
$0.00 |
| 2021 |
757 |
$0.00 |
| 2022 |
101 |
$0.00 |
| 2023 |
60 |
$0.00 |
| 2024 |
65 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90756 |
|
20 |
20 |
$0.00 |
| 0013A |
|
96 |
96 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
357 |
357 |
$0.00 |
| 0012A |
|
224 |
224 |
$0.00 |
| 90656 |
|
26 |
26 |
$0.00 |
| 90688 |
|
24 |
24 |
$0.00 |
| 0001A |
|
13 |
13 |
$0.00 |
| M0201 |
Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home |
31 |
31 |
$0.00 |
| 0011A |
|
237 |
237 |
$0.00 |
| 90686 |
|
195 |
195 |
$0.00 |
| 90694 |
|
46 |
46 |
$0.00 |
| 0064A |
|
75 |
75 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
14 |
14 |
$0.00 |