Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

HONOLULU PHARMACY, INC

NPI: 1366409286 · GLENDALE, CA 91204 · Community/Retail Pharmacy · NPI assigned 04/26/2006

$23K
Total Medicaid Paid
650
Total Claims
650
Beneficiaries
4
Codes Billed
2018-01
First Month
2018-10
Last Month

Provider Details

Authorized OfficialARUTYUNYAN, ARSEN (GENERAL MANAGER)
NPI Enumeration Date04/26/2006

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 650 $23K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T4535 Disposable liner/shield/guard/pad/undergarment, for incontinence, each 173 173 $11K
T4541 Incontinence product, disposable underpad, large, each 173 173 $9K
T4536 Incontinence product, protective underwear/pull-on, reusable, any size, each 173 173 $2K
A6250 Skin sealants, protectants, moisturizers, ointments, any type, any size 131 131 $65.01