WEST SIDE DRUG CO A CORP
NPI: 1780795377
· FIREBAUGH, CA 93622
· Community/Retail Pharmacy
· NPI assigned 08/31/2006
$40.51
Total Medicaid Paid
Provider Details
| Authorized Official | LOUIE, JEFF (TRES) |
| NPI Enumeration Date | 08/31/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
171 |
$33.28 |
| 2021 |
99 |
$0.00 |
| 2022 |
101 |
$0.00 |
| 2023 |
171 |
$7.23 |
| 2024 |
112 |
$0.00 |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
574 |
508 |
$39.94 |
| A4259 |
Lancets, per box of 100 |
80 |
79 |
$0.57 |