LONGS DRUG STORES CALIFORNIA LLC
NPI: 1245272061
· COVINA, CA 91723
· 332B00000X
$187.17
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
39 |
$187.17 |
| 2024 |
60 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 91322 |
|
13 |
13 |
$143.00 |
| 90480 |
|
26 |
26 |
$44.17 |
| 91320 |
|
17 |
17 |
$0.00 |
| 90662 |
|
17 |
17 |
$0.00 |
| G0008 |
Admin influenza virus vac |
26 |
26 |
$0.00 |