Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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PHARMACY ON 8TH LLC

NPI: 1467715821 · WELLMAN, IA 52356 · Community/Retail Pharmacy · NPI assigned 06/20/2012

$848.25
Total Medicaid Paid
120
Total Claims
88
Beneficiaries
3
Codes Billed
2021-03
First Month
2021-05
Last Month

Provider Details

Authorized OfficialDE JESUS-ROETLIN, MARIA THERESA (PHARMACY OWNER)
NPI Enumeration Date06/20/2012

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 120 $848.25

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
0012A 16 16 $531.09
0011A 25 15 $317.16
91301 79 57 $0.00