Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › IN › WEST LAFAYETTE › CUSTOMPP LLC

CUSTOMPP LLC

NPI: 1396011888 · WEST LAFAYETTE, IN 47906 · Pharmacy · NPI assigned 03/28/2012

$0.00
Total Medicaid Paid
1,678
Total Claims
1,074
Beneficiaries
10
Codes Billed
2018-10
First Month
2024-11
Last Month

Provider Details

Authorized OfficialHUTERA, MATTHEW (OWNER)
NPI Enumeration Date03/28/2012

Related Entities

Other providers sharing the same authorized official: HUTERA, MATTHEW

ProviderCityStateTotal Paid
MVPS LLC MONTE VISTA CO $57K
MANPS LLC MANCHESTER KY $11K
MVPS LLC MONTE VISTA CO $2K
MCKPS LLC MC KEE KY $698.82

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 142 $0.00
2019 97 $0.00
2020 701 $0.00
2021 44 $0.00
2022 210 $0.00
2023 197 $0.00
2024 287 $0.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
90662 524 287 $0.00
0124A 54 54 $0.00
91322 77 70 $0.00
91320 37 35 $0.00
90682 69 41 $0.00
0064A 47 47 $0.00
G0008 Administration of influenza virus vaccine 624 353 $0.00
90656 13 13 $0.00
90480 116 107 $0.00
90686 117 67 $0.00