LANCASTER HOMETOWN PHARMACY LLC
NPI: 1437618451
· LANCASTER, WI 53813
· Durable Medical Equipment & Medical Supplies
$457.92
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
| 2021 |
30 |
$457.92 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
| 0011A |
|
13 |
13 |
$457.92 |
| 91301 |
|
17 |
17 |
$0.00 |