Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › WA › FERNDALE › CUSTOM PRESCRIPTION SHOPPE LLC

CUSTOM PRESCRIPTION SHOPPE LLC

NPI: 1932288438 · FERNDALE, WA 98248 · Community/Retail Pharmacy · NPI assigned 11/03/2006

$150K
Total Medicaid Paid
28,000
Total Claims
27,993
Beneficiaries
3
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialFARIS, KEVIN (CEO)
NPI Enumeration Date11/03/2006

Related Entities

Other providers sharing the same authorized official: FARIS, KEVIN

ProviderCityStateTotal Paid
WESTERN PHARMACY GROUP LLC SAN DIEGO CA $385.32
WESTERN PHARMACY GROUP LLC CHULA VISTA CA $60.47

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 5,769 $33K
2019 5,556 $32K
2020 5,124 $26K
2021 3,929 $19K
2022 2,518 $13K
2023 3,154 $17K
2024 1,950 $10K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1999 Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" 13,088 13,087 $128K
A4927 Gloves, non-sterile, per 100 1,753 1,748 $22K
A9901 Dme delivery, set up, and/or dispensing service component of another hcpcs code 13,159 13,158 $0.00