Medicaid Provider Spending

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

OLD TOWN PHARMACY LLC

NPI: 1578754701 · MONETT, MO 65708 · Community/Retail Pharmacy · NPI assigned 08/05/2007

$45.65
Total Medicaid Paid
12
Total Claims
12
Beneficiaries
1
Codes Billed
2018-04
First Month
2018-04
Last Month

Provider Details

Authorized OfficialBECKER, SHANE (OWNER/MANAGER/PIC)
NPI Enumeration Date08/05/2007

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 12 $45.65

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
A4253 Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips 12 12 $45.65