HOLIDAY ISLAND PHARMACY, LLC
NPI: 1760025274
· HOLIDAY ISLAND, AR 72631
· Community/Retail Pharmacy
· NPI assigned 10/28/2019
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | PRICE, JEFFERY (OWNER/PHARMACIST) |
| NPI Enumeration Date | 10/28/2019 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
140 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 91301 |
|
28 |
28 |
$0.00 |
| 0011A |
|
51 |
50 |
$0.00 |
| 0012A |
|
39 |
39 |
$0.00 |
| 0064A |
|
22 |
22 |
$0.00 |