FOODLAND SUPER MARKET LIMITED
NPI: 1083959993
· KAPOLEI, HI 96707
· Community/Retail Pharmacy
· NPI assigned 12/04/2012
Provider Details
| Authorized Official | ADAMS, PATRICK (DIRECTOR OF PHARMACY) |
| NPI Enumeration Date | 12/04/2012 |
Related Entities
Other providers sharing the same authorized official: ADAMS, PATRICK
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
28 |
$138.16 |
| 2020 |
55 |
$392.80 |
| 2021 |
266 |
$3K |
| 2022 |
14 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
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 |