Supplier
Vandorn Pharmacy INC
Vandorn Pharmacy INC was paid $400.23 by Medicaid between Jan 2021 and Oct 2024, across 8 billing codes. Its largest line is 91322, — 73% of everything it billed.
33Billing provider infoVANDORN PHARMACY INC
ALEXANDRIA, VA 22304
ALEXANDRIA, VA 22304
33aNPI1174151716assigned 03/30/2020
33bProvider typeLong Term Care Pharmacy
28Total paid$400.23
24GClaims190
24DCodes billed8
24AFirst – last monthJan 2021 – Oct 2024
Compared with peers
Next to other Long Term Care Pharmacy providers in Virginia
Rank by total paid#5 of 6
Median peer was paid$414.15
This provider vs. median1.0×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
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 | |
|---|---|---|---|
| 2021 | 76 | $28.39 | |
| 2023 | 48 | $371.84 | |
| 2024incomplete | 66 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 91322 | 73% | 39 | 36 | $291.84 | |
| 90480 | 20% | 39 | 36 | $80.00 | |
| 0012A | 7.1% | 25 | 25 | $28.39 | |
| 0004A | 0% | 24 | 24 | $0.00 | |
| 90662 | 0% | 12 | 12 | $0.00 | |
| M0201 | Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home | 0% | 12 | 12 | $0.00 |
| G0008 | Administration of influenza virus vaccine | 0% | 12 | 12 | $0.00 |
| 0011A | 0% | 27 | 27 | $0.00 |
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 officialGULELAT, YODIT (OWNER/MANAGER)
Parent organizationVANDORN PHARMACY INC