Medicaid Provider Spending

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

PRESCRIPTION SHOP LLC

NPI: 1972694990 · PUEBLO, CO 81005 · Compounding Pharmacy · NPI assigned 09/27/2006

$28K
Total Medicaid Paid
2,292
Total Claims
2,100
Beneficiaries
4
Codes Billed
2018-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialSAJBEL, JAMES (OWNER/PHARMACIST)
Parent OrganizationPRESCRIPTION SHOP LLC
NPI Enumeration Date09/27/2006

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 385 $9K
2019 388 $5K
2020 410 $4K
2021 371 $3K
2022 336 $3K
2023 272 $2K
2024 130 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
A4253 Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips 2,003 1,828 $28K
A4259 Lancets, per box of 100 143 141 $504.47
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 77 68 $0.00
90756 69 63 $0.00