Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › HI › KAILUA › FOODLAND SUPERMARKET LTD

FOODLAND SUPERMARKET LTD

NPI: 1083772503 · KAILUA, HI 96734 · Pharmacy · NPI assigned 12/05/2006

$4K
Total Medicaid Paid
289
Total Claims
272
Beneficiaries
5
Codes Billed
2018-10
First Month
2022-01
Last Month

Provider Details

Authorized OfficialADAMS, PATRICK (DIRRECTOR OF PHARMACY)
NPI Enumeration Date12/05/2006

Related Entities

Other providers sharing the same authorized official: ADAMS, PATRICK

ProviderCityStateTotal Paid
FOODLAND SUPER MARKET LIMITED KAPOLEI HI $4K
FOODLAND SUPERMARKET LTD LAIE HI $125.60

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 36 $435.83
2019 31 $292.88
2020 45 $472.72
2021 164 $2K
2022 13 $563.16

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 138 131 $1K
0064A 28 28 $1K
90674 49 48 $1K
91301 50 49 $0.00
91306 24 16 $0.00