Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › CA › SAN GABRIEL › LUCKY PHARMACY INC

LUCKY PHARMACY INC

NPI: 1780685263 · SAN GABRIEL, CA 91776 · Compounding Pharmacy · NPI assigned 08/09/2005

$169.93
Total Medicaid Paid
116
Total Claims
116
Beneficiaries
3
Codes Billed
2023-10
First Month
2024-10
Last Month

Provider Details

Authorized OfficialYAN, SHIUFONG (PRESIDENT)
NPI Enumeration Date08/09/2005

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 84 $169.93
2024 32 $0.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
91320 31 31 $128.48
90480 53 53 $41.45
90653 32 32 $0.00