NPI: 1760479117 · LAFAYETTE, LA 70501 · Pharmacy · NPI assigned 09/30/2005
| Authorized Official | DARTEZ, RYAN (PRESIDENT, OWNER, PIC,AO) |
| NPI Enumeration Date | 09/30/2005 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 242 | $204.74 |
| 2019 | 318 | $325.90 |
| 2020 | 174 | $0.00 |
| 2021 | 594 | $0.00 |
| 2022 | 136 | $0.00 |
| 2023 | 136 | $0.00 |
| 2024 | 42 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A4253 | Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips | 108 | 105 | $530.64 |
| 0013A | 45 | 45 | $0.00 | |
| 0002A | 115 | 112 | $0.00 | |
| 90662 | 144 | 144 | $0.00 | |
| 0003A | 41 | 40 | $0.00 | |
| 90670 | 19 | 19 | $0.00 | |
| 90686 | 271 | 268 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 510 | 507 | $0.00 |
| 90656 | 17 | 17 | $0.00 | |
| 0012A | 65 | 65 | $0.00 | |
| G0009 | Administration of pneumococcal vaccine | 32 | 32 | $0.00 |
| 0011A | 66 | 66 | $0.00 | |
| 90677 | 13 | 13 | $0.00 | |
| 90674 | 58 | 58 | $0.00 | |
| 0001A | 114 | 114 | $0.00 | |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 24 | 24 | $0.00 |