Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › IA › GREENFIELD › GREENFIELD PHARMACY LLC

GREENFIELD PHARMACY LLC

NPI: 1720543812 · GREENFIELD, IA 50849 · Long Term Care Pharmacy · NPI assigned 02/04/2019

$4K
Total Medicaid Paid
324
Total Claims
291
Beneficiaries
9
Codes Billed
2021-03
First Month
2022-12
Last Month

Provider Details

Authorized OfficialWILLIS, LORI (ACQUISITIONS MANAGER)
NPI Enumeration Date02/04/2019

Related Entities

Other providers sharing the same authorized official: WILLIS, LORI

ProviderCityStateTotal Paid
NUDAK VENTURES, LLC WATERLOO IA $331K
NUDAK VENTURES LLC NEVADA IA $14K
PM ACQUISITION, LLC IOWA CITY IA $8K
NUDAK VENTURES LLC FAIRFIELD IA $6K
NUDAK VENTURES LLC WEST UNION IA $3K
NUDAK VENTURES LLC AMES IA $2K
NUDAK VENTURES LLC ACKLEY IA $1K
MOUNTAIN LAKE PHARMACY LLC MOUNTAIN LAKE MN $931.91
NUDAK VENTURES, LLC STORY CITY IA $672.00

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 149 $3K
2022 175 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
0011A 60 60 $1K
T5999 Supply, not otherwise specified 93 63 $1K
0012A 33 33 $776.00
90674 41 41 $570.36
0134A 12 12 $320.00
0064A 16 15 $319.98
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 43 41 $235.83
91313 12 12 $0.00
91301 14 14 $0.00