LONGS DRUG STORES CALIFORNIA LLC

NPI: 1174566491 · KANEOHE, HI 96744 · Durable Medical Equipment & Medical Supplies · NPI assigned 06/14/2006

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official COLBERT, SUSAN controls 20+ related entities in our dataset. Read more

$11K

Total Medicaid Paid

420

Total Claims

407

Beneficiaries

Codes Billed

2020-08

First Month

2024-10

Last Month

Provider Details

Authorized Official	COLBERT, SUSAN (DIRECTOR PAYER RELATIONS)
NPI Enumeration Date	06/14/2006

Other providers sharing the same authorized official: COLBERT, SUSAN

Provider	City	State	Total Paid
MONTANA CVS PHARMACY LLC	ANACONDA	MT	$15K
WISCONSIN CVS PHARMACY LLC	APPLETON	WI	$13K
WISCONSIN CVS PHARMACY LLC	GREEN BAY	WI	$10K
WISCONSIN CVS PHARMACY LLC	MILWAUKEE	WI	$5K
AMERICAN DRUG STORES DELAWARE LLC	FARGO	ND	$3K
WISCONSIN CVS PHARMACY LLC	WAUWATOSA	WI	$3K
WISCONSIN CVS PHARMACY LLC	KENOSHA	WI	$3K
WISCONSIN CVS PHARMACY LLC	CUDAHY	WI	$2K
WISCONSIN CVS PHARMACY LLC	JANESVILLE	WI	$938.31
CVS PHARMACY, INC.	BIG SPRING	TX	$900.03
GARFIELD BEACH CVS, L.L.C.	REDDING	CA	$493.69
HOOK-SUPERX LLC	TERRE HAUTE	IN	$424.35
WISCONSIN CVS PHARMACY LLC	GREEN BAY	WI	$310.51
GARFIELD BEACH CVS LLC	MISSION HILLS	CA	$301.55
GARFIELD BEACH CVS LLC	SAND CITY	CA	$210.35
GARFIELD BEACH CVS LLC	LOS ANGELES	CA	$173.03
GARFIELD BEACH CVS LLC	GARDENA	CA	$173.03
ARIZONA CVS STORES LLC	TUCSON	AZ	$118.58
GARFIELD BEACH CVS LLC	BURBANK	CA	$0.00
GARFIELD BEACH CVS LLC	SAN JOSE	CA	$0.00

Code	Description	Claims	Beneficiaries	Total Paid
0064A		77	77	$3K
91322		17	17	$2K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	197	187	$2K
90480		32	32	$1K
0012A		20	20	$873.60
90686		46	43	$763.62
0134A		13	13	$519.84
0011A		18	18	$492.10