Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › KS › NEODESHA › WELLS PHARMACY INC

WELLS PHARMACY INC

NPI: 1487736278 · NEODESHA, KS 66757 · Durable Medical Equipment & Medical Supplies · NPI assigned 10/20/2006

$707.91
Total Medicaid Paid
175
Total Claims
143
Beneficiaries
7
Codes Billed
2021-03
First Month
2023-11
Last Month

Provider Details

Authorized OfficialWELLS, PAULA (PRESIDENT)
NPI Enumeration Date10/20/2006

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 121 $195.91
2022 12 $0.00
2023 42 $512.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
91322 21 21 $512.00
0012A 32 24 $80.00
0011A 40 30 $75.91
0004A 23 23 $40.00
0054A 12 12 $0.00
90480 21 21 $0.00
91301 26 12 $0.00