Medicaid Provider Spending

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

TRINITY VALLEY PHARMACY, LLC

NPI: 1639180201 · GRANTS PASS, OR 97526 · Pharmacy · NPI assigned 08/10/2006

$30K
Total Medicaid Paid
1,085
Total Claims
958
Beneficiaries
6
Codes Billed
2018-01
First Month
2019-03
Last Month

Provider Details

Authorized OfficialFREE, CLARISSA (OWNER)
NPI Enumeration Date08/10/2006

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 958 $28K
2019 127 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
A4927 Gloves, non-sterile, per 100 473 435 $8K
T4535 Disposable liner/shield/guard/pad/undergarment, for incontinence, each 135 130 $7K
T4527 Adult sized disposable incontinence product, protective underwear/pull-on, large size, each 58 56 $5K
T4541 Incontinence product, disposable underpad, large, each 232 210 $4K
T4526 Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each 47 42 $4K
99606 140 85 $950.00