SEASIDE PHARMACY INC.
NPI: 1760804397
· REVERE, MA 02151
· Community/Retail Pharmacy
· NPI assigned 01/16/2014
$30.94
Total Medicaid Paid
Provider Details
| Authorized Official | VO, TU-ANH (OWNER/PRESIDENT) |
| NPI Enumeration Date | 01/16/2014 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
15 |
$0.00 |
| 2020 |
31 |
$0.00 |
| 2023 |
50 |
$30.94 |
| 2024 |
19 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90694 |
|
17 |
17 |
$30.94 |
| G0008 |
Administration of influenza virus vaccine |
86 |
86 |
$0.00 |
| 90688 |
|
12 |
12 |
$0.00 |