Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › IA › URBANDALE › PCA IOWA RX, LLC

PCA IOWA RX, LLC

NPI: 1104385806 · URBANDALE, IA 50322 · Pharmacy · NPI assigned 03/13/2019

$363.96
Total Medicaid Paid
38
Total Claims
38
Beneficiaries
3
Codes Billed
2024-10
First Month
2024-10
Last Month

Provider Details

Authorized OfficialPIETROWSKI, CRISTINA (EVP, CHIEF LEGAL OFFICER & SECRETAR)
NPI Enumeration Date03/13/2019

Related Entities

Other providers sharing the same authorized official: PIETROWSKI, CRISTINA

ProviderCityStateTotal Paid
TRILOGY HEALTHCARE OF NORTH BALTIMORE LLC NORTH BALTIMORE OH $20K
PCA-CORRECTIONS LLC INDIANAPOLIS IN $6K
PCA-CORRECTIONS LLC LOUISVILLE KY $5K
ARLINGTON DIALYSIS, LLC INDIANAPOLIS IN $2K
PCA-CORRECTIONS LLC HILLIARD OH $445.21
TRILOGY HEALTHCARE OF HANCOCK, LLC FINDLAY OH $0.00
PARAGON OUTPATIENT REHABILITATION SERVICES, LLC LOUISVILLE KY $0.00

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2024 38 $363.96

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
91322 13 13 $351.75
90480 13 13 $12.21
G0008 Administration of influenza virus vaccine 12 12 $0.00