Medicaid Provider Spending

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

NPI: 1275602518 · SERGEANT BLUFF, IA 51054 · Durable Medical Equipment & Medical Supplies · NPI assigned 11/08/2006

$1K
Total Medicaid Paid
66
Total Claims
62
Beneficiaries
3
Codes Billed
2021-04
First Month
2021-05
Last Month

Provider Details

Authorized OfficialJACKSON, STACEY (OWNER)
NPI Enumeration Date11/08/2006

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 66 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
0011A 16 16 $640.00
0012A 12 12 $480.00
91301 38 34 $0.00