PINE BROOK PHARMACY LLC
NPI: 1558596932
· BROOKSVILLE, FL 34613
· Long Term Care Pharmacy
· NPI assigned 05/28/2009
$118.88
Total Medicaid Paid
Provider Details
| Authorized Official | THAKKAR, HEENA (PRESIDENT) |
| NPI Enumeration Date | 05/28/2009 |
Related Entities
Other providers sharing the same authorized official: THAKKAR, HEENA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
569 |
$118.88 |
| 2022 |
16 |
$0.00 |
| 2023 |
154 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0012A |
|
218 |
203 |
$77.76 |
| 0011A |
|
222 |
206 |
$41.12 |
| M0201 |
Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home |
75 |
53 |
$0.00 |
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
16 |
16 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
24 |
19 |
$0.00 |
| 90480 |
|
48 |
27 |
$0.00 |
| 0013A |
|
86 |
86 |
$0.00 |
| 91322 |
|
50 |
29 |
$0.00 |