NPI: 1972672822 · LAGRANGE, IN 46761 · Pharmacy · NPI assigned 11/07/2006
| Authorized Official | CRAWFORD, BRADLEY (PHARMACY MANAGER) |
| NPI Enumeration Date | 11/07/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 14 | $86.53 |
| 2021 | 36 | $0.00 |
| 2022 | 80 | $0.00 |
| 2023 | 81 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A4253 | Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips | 14 | 12 | $86.53 |
| G0008 | Administration of influenza virus vaccine | 75 | 75 | $0.00 |
| 90480 | 20 | 20 | $0.00 | |
| 90674 | 35 | 35 | $0.00 | |
| 0134A | 19 | 19 | $0.00 | |
| 0013A | 15 | 15 | $0.00 | |
| 90756 | 13 | 13 | $0.00 | |
| 91320 | 20 | 20 | $0.00 |