Upstate Pharmacy LTD

Upstate Pharmacy LTD was paid $99K by Medicaid between Jan 2018 and Jul 2024, across 5 billing codes. Its largest line is B4100, Food thickener, administered orally, per ounce — 91% of everything it billed.

33Billing provider infoUPSTATE PHARMACY LTD
WEST SENECA, NY 14224

33aNPI1033221031assigned 08/31/2006

33bProvider typePharmacy

28Total paid$99K

24GClaims4,503

24DCodes billed5

24AFirst – last monthJan 2018 – Jul 2024

Compared with peers

Next to other Pharmacy providers in New York

Rank by total paid#26 of 126

Median peer was paid$2K

This provider vs. median42×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

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

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
B4100	Food thickener, administered orally, per ounce	91%	1,461	1,247	$91K
A4253	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	3.1%	653	639	$3K
Q0513	Pharmacy dispensing fee for inhalation drug(s); per 30 days	2.8%	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	2.6%	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	<1%	52	50	$209.76

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialKUZNIRREK, TED (VP)