Medicaid Provider Spending

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

1063515831

NPI: 1063515831

Deactivated NPI · This NPI was deactivated on 11/04/2025.
$1K
Total Medicaid Paid
209
Total Claims
175
Beneficiaries
4
Codes Billed
2018-01
First Month
2020-11
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 75 $0.00
2020 134 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 77 59 $731.50
90686 43 29 $276.67
A4253 Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips 75 73 $0.00
90471CG 14 14 $0.00