Medicaid Provider Spending

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

NPI: 1629613005 · PLYMOUTH, MN 55442 · Long Term Care Pharmacy · NPI assigned 11/09/2019

$489.99
Total Medicaid Paid
167
Total Claims
167
Beneficiaries
4
Codes Billed
2023-10
First Month
2023-11
Last Month

Provider Details

Authorized OfficialLYTWYN, JILL (CEO)
NPI Enumeration Date11/09/2019

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 167 $489.99

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
91320 41 41 $254.16
90480 43 43 $235.83
90686 33 33 $0.00
G0008 Administration of influenza virus vaccine 50 50 $0.00