Medicaid Provider Spending

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

PERSON STREET PHARMACY LLC

NPI: 1831500032 · RALEIGH, NC 27604 · Pharmacy · NPI assigned 05/12/2014

$1K
Total Medicaid Paid
27
Total Claims
25
Beneficiaries
2
Codes Billed
2021-04
First Month
2021-05
Last Month

Provider Details

Authorized OfficialWATERS, WESLEY (MANAGER)
NPI Enumeration Date05/12/2014

Related Entities

Other providers sharing the same authorized official: WATERS, WESLEY

ProviderCityStateTotal Paid
RICHLANDS PHARMACY ASSOCIATES INC RICHLANDS VA $144.22

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 27 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
0011A 14 13 $617.50
0012A 13 12 $585.00