Supplier
Vidrine Pharmaceutical Group, LLC
Vidrine Pharmaceutical Group, LLC was paid $15.92 by Medicaid between Feb 2021 and Jan 2022, across 7 billing codes. Its largest line is 0001A, — 100% of everything it billed.
33Billing provider infoVIDRINE PHARMACEUTICAL GROUP, LLC
LAKE CHARLES, LA 70601
LAKE CHARLES, LA 70601
33aNPI1043838469assigned 07/13/2020
33bProvider typeCompounding Pharmacy
28Total paid$15.92
24GClaims740
24DCodes billed7
24AFirst – last monthFeb 2021 – Jan 2022
Compared with peers
Next to other Compounding Pharmacy providers in Louisiana
Rank by total paid#3 of 6
Median peer was paid$0.00
This provider vs. median0.0×
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 | |
|---|---|---|---|
| 2021 | 683 | $15.92 | |
| 2022 | 57 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 0001A | 100% | 113 | 103 | $15.92 | |
| 0013A | 0% | 164 | 164 | $0.00 | |
| 0002A | 0% | 76 | 74 | $0.00 | |
| 0003A | 0% | 91 | 91 | $0.00 | |
| 0012A | 0% | 133 | 129 | $0.00 | |
| 0011A | 0% | 151 | 143 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 12 | 12 | $0.00 |
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 officialVIDRINE, JESSE (OWNER)
Parent organizationVIDRINE PHARMACEUTICAL GROUP, LLC