Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › SC › KINGSTREE › BLACK RIVER MEDICAL SUPPLIES AND EQUIPMENT, LLC

BLACK RIVER MEDICAL SUPPLIES AND EQUIPMENT, LLC

NPI: 1912654989 · KINGSTREE, SC 29556 · Oxygen Equipment & Supplies (DME) · NPI assigned 03/09/2022

$9K
Total Medicaid Paid
376
Total Claims
372
Beneficiaries
3
Codes Billed
2023-09
First Month
2024-11
Last Month

Provider Details

Authorized OfficialMITCHELL, VICKIE (CO-OWNER)
NPI Enumeration Date03/09/2022

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 25 $134.50
2024 351 $9K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
X1939 85 83 $6K
A4554 Disposable underpads, all sizes 57 57 $2K
T5999 Supply, not otherwise specified 234 232 $2K