Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › HI › EWA BEACH › SAFEWAY INC

SAFEWAY INC

NPI: 1386996353 · EWA BEACH, HI 96706 · Durable Medical Equipment & Medical Supplies · NPI assigned 10/15/2012

$21K
Total Medicaid Paid
581
Total Claims
581
Beneficiaries
11
Codes Billed
2021-04
First Month
2022-10
Last Month

Provider Details

Authorized OfficialELIOPULOS, TIFFANY (ASSISTANT MANAGER, ENROLLMENTS)
NPI Enumeration Date10/15/2012

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 464 $17K
2022 117 $4K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
0001A 168 168 $6K
0002A 158 158 $6K
0004A 41 41 $2K
0054A 45 45 $2K
90682 28 28 $1K
0124A 25 25 $909.72
0012A 19 19 $829.92
0011A 18 18 $786.24
0064A 14 14 $567.84
G0008 Administration of influenza virus vaccine 52 52 $501.84
90686 13 13 $195.80