Supplier
Legacy Apothecary
Legacy Apothecary was paid $2K by Medicaid between Sep 2018 and Sep 2023, across 8 billing codes. Its largest line is 90674, — 60% of everything it billed.
33Billing provider infoLEGACY APOTHECARY
WACONIA, MN 55387
WACONIA, MN 55387
33aNPI1669837530assigned 12/21/2015
33bProvider typeCompounding Pharmacy
28Total paid$2K
24GClaims1,062
24DCodes billed8
24AFirst – last monthSep 2018 – Sep 2023
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 108 | $0.00 | |
| 2019 | 122 | $0.00 | |
| 2020 | 156 | $0.00 | |
| 2021 | 183 | $530.91 | |
| 2022 | 344 | $733.32 | |
| 2023 | 149 | $583.04 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 90674 | 60% | 232 | 232 | $1K | |
| 0064A | 29% | 66 | 66 | $526.50 | |
| 90686 | 11% | 208 | 208 | $206.82 | |
| 91313 | 0% | 17 | 17 | $0.00 | |
| 0013A | 0% | 44 | 44 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 398 | 398 | $0.00 |
| 0134A | 0% | 83 | 83 | $0.00 | |
| 91306 | 0% | 14 | 14 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialLOEGERING, RYAN (PRESIDENT)