Medicaid Provider Spending

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

GOOD VALUE PHARMACY LLC

NPI: 1164509949 · WEST ALLIS, WI 53214 · 3336S0011X

$663.00

Total Medicaid Paid

24

Total Claims

22

Beneficiaries

1

Codes Billed

2018-10

First Month

2018-10

Last Month

Monthly Spending Trend

Yearly Breakdown

Year	Claims	Total Paid
2018	24	$663.00

Billing Codes

Code	Description	Claims	Beneficiaries	Total Paid
90686		24	22	$663.00