Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › FL › ORANGE CITY › LEGACY PHARMACY OC LLC

LEGACY PHARMACY OC LLC

NPI: 1487098513 · ORANGE CITY, FL 32763 · Community/Retail Pharmacy · NPI assigned 04/19/2013

$197.76
Total Medicaid Paid
34
Total Claims
29
Beneficiaries
1
Codes Billed
2021-09
First Month
2021-11
Last Month

Provider Details

Authorized OfficialSMART, DIPTI (PARTNER)
NPI Enumeration Date04/19/2013

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 34 $197.76

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
0001A 34 29 $197.76