Medicaid Provider Spending

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

ACTS PHARMACY AND HEALTHCARE SERVICES, LLC

NPI: 1720564925 · TACOMA, WA 98405 · Clinic Pharmacy · NPI assigned 07/11/2018

$22K
Total Medicaid Paid
916
Total Claims
891
Beneficiaries
14
Codes Billed
2022-08
First Month
2024-11
Last Month

Provider Details

Authorized OfficialBAUTISTA, JAZEL JANE (GOVERNOR/PHARMACIST-IN-CHARGE)
NPI Enumeration Date07/11/2018

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 247 $4K
2023 136 $3K
2024 533 $15K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 147 144 $9K
90715 271 259 $4K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 173 172 $3K
90472 Immunization administration, each additional vaccine (list separately) 91 90 $2K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 12 12 $687.87
90713 35 32 $616.35
90651 65 64 $604.36
90710 28 27 $517.90
90674 17 17 $338.48
90700 17 17 $315.04
90744 20 17 $295.35
90716 15 15 $236.28
90707 12 12 $216.59
90661 13 13 $34.06