KROGER SPECIALTY PHARMACY FL 2 LLC
NPI: 1508146010
· ORLANDO, FL 32822
· 332B00000X
$1.32M
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
591 |
$26K |
| 2019 |
1,387 |
$69K |
| 2020 |
1,200 |
$1.16M |
| 2021 |
912 |
$53K |
| 2022 |
85 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4105 |
Enzyme cartridge enteral nut |
125 |
51 |
$1.09M |
| J7639 |
Dornase alfa non-comp unit |
1,777 |
986 |
$218K |
| J7682 |
Tobramycin non-comp unit |
71 |
38 |
$6K |
| Q0513 |
Disp fee inhal drugs/30 days |
1,703 |
1,073 |
$2K |
| J7613 |
Albuterol non-comp unit |
499 |
279 |
$735.18 |