Medicaid Provider Spending

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

PEVELY RX

NPI: 1790034064 · PEVELY, MO 63070 · Compounding Pharmacy · NPI assigned 09/02/2012

$56K
Total Medicaid Paid
863
Total Claims
831
Beneficiaries
3
Codes Billed
2023-05
First Month
2023-12
Last Month

Provider Details

Authorized OfficialWANG, JASON (PRESIDENT)
NPI Enumeration Date09/02/2012

Related Entities

Other providers sharing the same authorized official: WANG, JASON

ProviderCityStateTotal Paid
DESERT PEDIATRICS, LLC EL PASO TX $97K
TOMLYN, INC AFFTON MO $55K
MS MGC INC MONTGOMERY CITY MO $900.00

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 863 $56K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99607 440 424 $39K
99606 362 352 $13K
99605 61 55 $4K