Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

UPSTATE PHARMACY LTD

NPI: 1033221031 · WEST SENECA, NY 14224 · Pharmacy · NPI assigned 08/31/2006

$99K
Total Medicaid Paid
4,503
Total Claims
4,080
Beneficiaries
5
Codes Billed
2018-01
First Month
2024-07
Last Month

Provider Details

Authorized OfficialKUZNIRREK, TED (VP)
NPI Enumeration Date08/31/2006

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 997 $43K
2019 1,264 $35K
2020 1,073 $17K
2021 488 $3K
2022 310 $659.83
2023 148 $603.74
2024 223 $429.02

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
B4100 Food thickener, administered orally, per ounce 1,461 1,247 $91K
A4253 Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips 653 639 $3K
Q0513 Pharmacy dispensing fee for inhalation drug(s); per 30 days 1,504 1,449 $3K
J7626 Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg 833 695 $3K
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme 52 50 $209.76