Honolulu Pharmacy, INC

Honolulu Pharmacy, INC was paid $23K by Medicaid between Jan 2018 and Oct 2018, across 4 billing codes. Its largest line is T4535, Disposable liner/shield/guard/pad/undergarment, for incontinence, each — 49% of everything it billed.

33Billing provider infoHONOLULU PHARMACY, INC
GLENDALE, CA 91204

33aNPI1366409286assigned 04/26/2006

33bProvider typeCommunity/Retail Pharmacy

28Total paid$23K

24GClaims650

24DCodes billed4

24AFirst – last monthJan 2018 – Oct 2018

Compared with peers

Next to other Community/Retail Pharmacy providers in California

Rank by total paid#24 of 366

Median peer was paid$195.39

This provider vs. median117×

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
2018	650	$23K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
T4535	Disposable liner/shield/guard/pad/undergarment, for incontinence, each	49%	173	173	$11K
T4541	Incontinence product, disposable underpad, large, each	41%	173	173	$9K
T4536	Incontinence product, protective underwear/pull-on, reusable, any size, each	9.1%	173	173	$2K
A6250	Skin sealants, protectants, moisturizers, ointments, any type, any size	<1%	131	131	$65.01

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 officialARUTYUNYAN, ARSEN (GENERAL MANAGER)