CUSTOM PRESCRIPTION SHOPPE LLC
NPI: 1932288438
· FERNDALE, WA 98248
· 3336C0003X
$150K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total 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
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1999 |
Noc retail items andsupplies |
13,088 |
13,087 |
$128K |
| A4927 |
Non-sterile gloves |
1,753 |
1,748 |
$22K |
| A9901 |
Delivery/set up/dispensing |
13,159 |
13,158 |
$0.00 |