Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › OR › SHADY COVE › CENTRAL DRUG STORE INC

CENTRAL DRUG STORE INC

NPI: 1790830446 · SHADY COVE, OR 97539 · Pharmacy · NPI assigned 01/24/2007

$24.22
Total Medicaid Paid
16
Total Claims
13
Beneficiaries
1
Codes Billed
2021-03
First Month
2021-03
Last Month

Provider Details

Authorized OfficialLICHLYTER, TIMOTHY (PRESIDENT)
NPI Enumeration Date01/24/2007

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 16 $24.22

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
0011A 16 13 $24.22