DAVE'S SUPERMARKETS INC.
NPI: 1851597124
· CLEVELAND HEIGHTS, OH 44118
· Community/Retail Pharmacy
· NPI assigned 06/25/2007
$238.31
Total Medicaid Paid
Provider Details
| Authorized Official | WOLFE, JOEL (PHARMACY MANAGER) |
| NPI Enumeration Date | 06/25/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
205 |
$238.31 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
186 |
165 |
$233.21 |
| A4259 |
Lancets, per box of 100 |
19 |
17 |
$5.10 |