LONGS DRUG STORES CALIFORNIA LLC

NPI: 1205203544 · HONOLULU, HI 96821 · Durable Medical Equipment & Medical Supplies · NPI assigned 08/21/2015

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

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

$39K

Total Medicaid Paid

1,107

Total Claims

1,102

Beneficiaries

Codes Billed

2021-03

First Month

2023-10

Last Month

Provider Details

Authorized Official	COLBERT, SUSAN (DIRECTOR PAYER RELATIONS)
NPI Enumeration Date	08/21/2015

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
0002A		361	361	$15K
0001A		325	325	$11K
0004A		141	141	$6K
91322		19	19	$2K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	123	120	$1K
0124A		36	36	$1K
0054A		27	27	$996.36
90480		20	20	$786.24
90686		42	40	$737.99
90674		13	13	$355.08