RITE AID OF PENNSYLVANIA LLC
NPI: 1386822336
· ETTERS, PA 17319
· 332B00000X
$707K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
131 |
$2K |
| 2019 |
598 |
$6K |
| 2020 |
147 |
$2K |
| 2021 |
170 |
$3K |
| 2022 |
5,081 |
$85K |
| 2023 |
12,808 |
$269K |
| 2024 |
8,902 |
$340K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90750 |
|
1,369 |
1,362 |
$183K |
| 90677 |
|
796 |
796 |
$150K |
| G0008 |
Admin influenza virus vac |
10,578 |
10,456 |
$72K |
| 91320 |
|
798 |
797 |
$51K |
| 91322 |
|
646 |
646 |
$48K |
| 90656 |
|
2,015 |
2,015 |
$44K |
| 90661 |
|
1,007 |
1,007 |
$36K |
| 90686 |
|
3,785 |
3,748 |
$23K |
| 90674 |
|
2,916 |
2,882 |
$19K |
| 90679 |
|
190 |
189 |
$19K |
| 90471 |
|
2,292 |
2,272 |
$18K |
| 0124A |
|
480 |
480 |
$13K |
| 90678 |
|
128 |
127 |
$9K |
| 90746 |
|
160 |
160 |
$9K |
| 90673 |
|
32 |
32 |
$3K |
| 90472 |
|
224 |
222 |
$2K |
| 90653 |
|
88 |
88 |
$2K |
| 90739 |
|
12 |
12 |
$2K |
| 91304 |
|
13 |
13 |
$2K |
| 90694 |
|
201 |
201 |
$888.48 |
| 0134A |
|
40 |
40 |
$792.00 |
| 90480 |
|
34 |
34 |
$123.42 |
| 90662 |
|
15 |
15 |
$77.00 |
| G0009 |
Admin pneumococcal vaccine |
18 |
18 |
$0.00 |