Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › HI › KAPOLEI › FOODLAND SUPER MARKET LIMITED

FOODLAND SUPER MARKET LIMITED

NPI: 1083959993 · KAPOLEI, HI 96707 · 3336C0003X

$4K
Total Medicaid Paid
363
Total Claims
350
Beneficiaries
11
Codes Billed
2018-10
First Month
2022-01
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 28 $138.16
2020 55 $392.80
2021 266 $3K
2022 14 $0.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
90471 77 75 $731.92
0001A 14 14 $611.52
0012A 42 42 $552.24
0002A 13 13 $524.16
90674 20 20 $449.10
0011A 45 43 $390.39
0064A 20 20 $262.08
91300 57 50 $0.00
90662 12 12 $0.00
91301 49 47 $0.00
90686 14 14 $0.00