SOUTH SIDE DRUG INC
NPI: 1801817879
· OTTUMWA, IA 52501
· Durable Medical Equipment & Medical Supplies
· NPI assigned 07/22/2006
$276.55
Total Medicaid Paid
Provider Details
| Authorized Official | FRAHM, MARK (VICE PRESIDENT) |
| NPI Enumeration Date | 07/22/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
87 |
$158.38 |
| 2019 |
70 |
$47.25 |
| 2020 |
90 |
$54.28 |
| 2021 |
115 |
$0.00 |
| 2022 |
13 |
$16.64 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
293 |
248 |
$276.55 |
| 0012A |
|
13 |
12 |
$0.00 |
| 91301 |
|
42 |
31 |
$0.00 |
| 0011A |
|
27 |
16 |
$0.00 |