HOMETOWN LTC PHARMACY INC
NPI: 1598108847
· SANTA MARIA, CA 93455
· 332800000X
$139K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
86 |
$6K |
| 2019 |
345 |
$17K |
| 2020 |
417 |
$21K |
| 2021 |
213 |
$9K |
| 2022 |
506 |
$33K |
| 2023 |
506 |
$37K |
| 2024 |
257 |
$17K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Large disposable underpad |
1,403 |
1,357 |
$68K |
| T4523 |
Adult size brief/diaper lg |
398 |
395 |
$35K |
| T4527 |
Adult size pull-on lg |
232 |
230 |
$16K |
| T4528 |
Adult size pull-on xl |
92 |
90 |
$8K |
| T4522 |
Adult size brief/diaper med |
70 |
70 |
$5K |
| T4526 |
Adult size pull-on med |
41 |
39 |
$3K |
| T4524 |
Adult size brief/diaper xl |
26 |
25 |
$2K |
| T4535 |
Disposable liner/shield/pad |
15 |
14 |
$811.08 |
| 90662 |
|
13 |
13 |
$0.00 |
| G0008 |
Admin influenza virus vac |
27 |
27 |
$0.00 |
| 90674 |
|
13 |
13 |
$0.00 |