Medicaid Provider Spending

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

JOHNSTON COUNTY PHARMACIES INC

NPI: 1609295716 · FOUR OAKS, NC 27524 · Community/Retail Pharmacy · NPI assigned 04/16/2014

$5K
Total Medicaid Paid
245
Total Claims
206
Beneficiaries
5
Codes Billed
2019-09
First Month
2021-05
Last Month

Provider Details

Authorized OfficialLEQUIRE, MITCHELL (PRESIDENT)
NPI Enumeration Date04/16/2014

Related Entities

Other providers sharing the same authorized official: LEQUIRE, MITCHELL

ProviderCityStateTotal Paid
REALO DISCOUNT DRUG STORES OF JOHNSTON COUNTY, INC SMITHFIELD NC $5K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2019 30 $399.57
2021 215 $5K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
0012A 41 38 $2K
0011A 53 46 $2K
90688 15 14 $213.37
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 15 14 $186.20
91301 121 94 $0.00