Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › GU › DEDEDO › MARIANO PRIME LIMITED LIABILITY

MARIANO PRIME LIMITED LIABILITY

NPI: 1518003136 · DEDEDO, GU 96929 · Pharmacy · NPI assigned 01/30/2007

$13K
Total Medicaid Paid
1,418
Total Claims
1,383
Beneficiaries
3
Codes Billed
2020-03
First Month
2024-10
Last Month

Provider Details

Authorized OfficialMARIANO, ARTHUR (OWNER)
NPI Enumeration Date01/30/2007

Related Entities

Other providers sharing the same authorized official: MARIANO, ARTHUR

ProviderCityStateTotal Paid
MARIANO PRIME LIMITED LIABILITY TAMUNING GU $5K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 107 $982.80
2021 173 $2K
2022 462 $5K
2023 373 $4K
2024 303 $3K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
A4211 Supplies for self-administered injections 837 815 $8K
A4253 Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips 428 416 $5K
A4259 Lancets, per box of 100 153 152 $217.26