Supplier
Lucky Pharmacy INC
Lucky Pharmacy INC was paid $169.93 by Medicaid between Oct 2023 and Oct 2024, across 3 billing codes. Its largest line is 91320, — 76% of everything it billed.
33Billing provider infoLUCKY PHARMACY INC
SAN GABRIEL, CA 91776
SAN GABRIEL, CA 91776
33aNPI1780685263assigned 08/09/2005
33bProvider typeCompounding Pharmacy
28Total paid$169.93
24GClaims116
24DCodes billed3
24AFirst – last monthOct 2023 – Oct 2024
Compared with peers
Next to other Compounding Pharmacy providers in California
Rank by total paid#16 of 21
Median peer was paid$6K
This provider vs. median0.0×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
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 | |
|---|---|---|---|
| 2023 | 84 | $169.93 | |
| 2024incomplete | 32 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 91320 | 76% | 31 | 31 | $128.48 | |
| 90480 | 24% | 53 | 53 | $41.45 | |
| 90653 | 0% | 32 | 32 | $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 officialYAN, SHIUFONG (PRESIDENT)