Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › AR › LITTLE ROCK › NW OTTER CREEK LLC

NW OTTER CREEK LLC

NPI: 1285167502 · LITTLE ROCK, AR 72210 · Community/Retail Pharmacy · NPI assigned 04/04/2017

$39K
Total Medicaid Paid
4,723
Total Claims
3,093
Beneficiaries
13
Codes Billed
2021-03
First Month
2022-11
Last Month

Provider Details

Authorized OfficialFAROOQ, UMAR (PRESIDENT)
NPI Enumeration Date04/04/2017

Related Entities

Other providers sharing the same authorized official: FAROOQ, UMAR

ProviderCityStateTotal Paid
KNIGHTS MEDICAL ASSOCIATES PC BENSALEM PA $709K
NW CANTRELL LLC LITTLE ROCK AR $2K
NW CABOT LLC CABOT AR $67.95
SCPG ARKANSAS LLC PARIS AR $36.59
SCPG ARKANSAS LLC PRESCOTT AR $0.00
SCPG ARKANSAS LLC HOT SPRINGS AR $0.00
NW SHERWOOD LLC SHERWOOD AR $0.00

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 3,962 $34K
2022 761 $5K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
0071A 559 326 $13K
0072A 344 196 $8K
0001A 395 294 $7K
0002A 331 244 $7K
0064A 175 105 $1K
0004A 59 26 $800.00
G0008 Administration of influenza virus vaccine 107 84 $772.50
90688 42 39 $571.65
0011A 122 113 $220.22
91307 937 524 $2.54
91300 992 650 $2.43
91301 601 433 $1.14
0012A 59 59 $0.00