Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

LAKE SUCCESS RX CORP

NPI: 1508526328 · NEW HYDE PARK, NY 11040 · Community/Retail Pharmacy · NPI assigned 12/20/2021

$466.32
Total Medicaid Paid
379
Total Claims
378
Beneficiaries
1
Codes Billed
2023-03
First Month
2024-10
Last Month

Provider Details

Authorized OfficialZAVULUNOV, STANISLAV (PRESIDENT)
NPI Enumeration Date12/20/2021

Related Entities

Other providers sharing the same authorized official: ZAVULUNOV, STANISLAV

ProviderCityStateTotal Paid
LITTLE NECK RX CORP LITTLE NECK NY $98.77
HCOR SPECIALTY PHARMACY LLC FOREST HILLS NY $45.75

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 181 $297.17
2024 198 $169.15

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
E0570 Nebulizer, with compressor 379 378 $466.32