Peninsula Pharmacy INC
Peninsula Pharmacy INC was paid $503K by Medicaid between Jan 2018 and Nov 2024, across 19 billing codes. Its largest line is B4150, Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit — 31% of everything it billed.
33Billing provider infoPENINSULA PHARMACY INC
MARQUETTE, MI 49855
MARQUETTE, MI 49855
33aNPI1003807413assigned 11/03/2005
33bProvider typePharmacist
28Total paid$503K
24GClaims5,311
24DCodes billed19
24AFirst – last monthJan 2018 – Nov 2024
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 269 | $30K | |
| 2019 | 1,628 | $131K | |
| 2020 | 1,583 | $127K | |
| 2021 | 424 | $46K | |
| 2022 | 488 | $50K | |
| 2023 | 481 | $54K | |
| 2024incomplete | 438 | $64K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| B4150 | Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | 31% | 1,517 | 1,464 | $156K |
| E0603 | Breast pump, electric (ac and/or dc), any type | 14% | 510 | 510 | $68K |
| A4239 | Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | 11% | 317 | 316 | $58K |
| A4335 | Incontinence supply; miscellaneous | 11% | 685 | 659 | $54K |
| T4528 | Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each | 6.2% | 265 | 254 | $31K |
| T4535 | Disposable liner/shield/guard/pad/undergarment, for incontinence, each | 6.1% | 788 | 742 | $31K |
| T4526 | Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each | 5.4% | 208 | 198 | $27K |
| T4527 | Adult sized disposable incontinence product, protective underwear/pull-on, large size, each | 5.1% | 185 | 179 | $26K |
| B4152 | Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit | 4.5% | 160 | 160 | $23K |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 2.7% | 71 | 63 | $14K |
| T4542 | Incontinence product, disposable underpad, small size, each | 2.0% | 330 | 316 | $10K |
| 99605 | <1% | 45 | 45 | $2K |
7 more codes
| A4253 | Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips | <1% | 29 | $1K |
| 99607 | <1% | 61 | $830.00 | |
| S5199 | Personal care item, nos, each | <1% | 36 | $627.50 |
| E0240 | Bath/shower chair, with or without wheels, any size | <1% | 12 | $429.38 |
| A4452 | Tape, waterproof, per 18 square inches | <1% | 47 | $413.27 |
| A4927 | Gloves, non-sterile, per 100 | <1% | 33 | $317.76 |
| T4541 | Incontinence product, disposable underpad, large, each | <1% | 12 | $285.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialCHALLA, PRAVEEN (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Sai Coopers LLC | Vass, NC | $159.26 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.