Medicaid Provider Spending

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

SPARTAN PHARMACY INC

NPI: 1891706461 · PITTSBURGH, PA 15227 · Pharmacy · NPI assigned 08/10/2006

$44K
Total Medicaid Paid
918
Total Claims
858
Beneficiaries
7
Codes Billed
2021-09
First Month
2023-11
Last Month

Provider Details

Authorized OfficialRICE, ADAM (PRESIDENT)
NPI Enumeration Date08/10/2006

Related Entities

Other providers sharing the same authorized official: RICE, ADAM

ProviderCityStateTotal Paid
OLYMPUS INFUSIONS INC PITTSBURGH PA $97K
SPARTAN PHARMACY INC BETHEL PARK PA $264.00

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 447 $21K
2022 409 $21K
2023 62 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
M0247 Intravenous infusion, sotrovimab, includes infusion and post administration monitoring 75 75 $22K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 395 364 $13K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 272 249 $5K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 76 75 $3K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 60 56 $690.00
90756 23 22 $683.18
90674 17 17 $187.00