CARLIE CS OF MEMORIAL DRIVE LLC
NPI: 1891940060
· GOLDSBORO, NC 27534
· Community/Retail Pharmacy
· NPI assigned 12/01/2008
$439.46
Total Medicaid Paid
Provider Details
| Authorized Official | ARNOLD, REBECCA (PHARMACY MANAGER) |
| NPI Enumeration Date | 12/01/2008 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
29 |
$439.46 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90686 |
|
14 |
14 |
$253.26 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
14 |
$186.20 |