Medicaid Provider Spending

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

S & R KEYSTONE PHARMACY LLC

NPI: 1063509255 · BALTIMORE, MD 21217 · Pharmacy · NPI assigned 10/07/2006

$4K
Total Medicaid Paid
492
Total Claims
469
Beneficiary Records
1
Codes Billed
2018-03
First Month
2022-02
Last Month

Provider Details

Authorized OfficialPOTLURI, SYAM (MANAGING MEMBER)
NPI Enumeration Date10/07/2006

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 162 $2K
2019 122 $863.14
2020 170 $1K
2021 13 $56.58
2022 25 $128.14

Billing Codes

CodeDescriptionClaimsBene. RecordsTotal Paid
A4253 Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips 492 469 $4K