HOLIDAY CVS LLC

NPI: 1497859300 · HIALEAH, FL 33016 · Community/Retail Pharmacy · NPI assigned 09/12/2006

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

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

$9K

Total Medicaid Paid

1,267

Total Claims

994

Beneficiaries

Codes Billed

2018-01

First Month

2022-01

Last Month

Provider Details

Authorized Official	COLBERT, SUSAN (EXEC DIR, RX SERVICES)
NPI Enumeration Date	09/12/2006

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
A4253	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	763	567	$9K
0004A		92	69	$160.00
0002A		171	150	$123.70
0001A		186	159	$88.58
0003A		40	35	$0.00
Q0513	Pharmacy dispensing fee for inhalation drug(s); per 30 days	15	14	$0.00