HOLLY STREET DRUGS, LLC
NPI: 1801927017
· HOLLY HILL, SC 29059
· Durable Medical Equipment & Medical Supplies
· NPI assigned 03/08/2007
$640.56
Total Medicaid Paid
Provider Details
| Authorized Official | OSTEEN, RACHEL (PLC/OWNER) |
| NPI Enumeration Date | 03/08/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
68 |
$640.56 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
12 |
12 |
$366.72 |
| T5999 |
Supply, not otherwise specified |
56 |
56 |
$273.84 |