CLAN CORPORATION
NPI: 1750443446
· DEDEDO, GU 96929
· Pharmacist
· NPI assigned 12/16/2006
$979.60
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
108 |
$979.60 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4211 |
Supplies for self-administered injections |
73 |
69 |
$648.00 |
| A4206 |
Syringe with needle, sterile, 1 cc or less, each |
35 |
34 |
$331.60 |