BONHAMTOWN PHARMACY LLC
NPI: 1730787938
· EDISON, NJ 08837
· Community/Retail Pharmacy
· NPI assigned 10/12/2020
$384.00
Total Medicaid Paid
Provider Details
| Authorized Official | SHAH, ANKUR (OPERATING PARTNER) |
| NPI Enumeration Date | 10/12/2020 |
Related Entities
Other providers sharing the same authorized official: SHAH, ANKUR
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
227 |
$384.00 |
| 2023 |
235 |
$0.00 |
| 2024 |
42 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
150 |
141 |
$384.00 |
| 91322 |
|
24 |
24 |
$0.00 |
| 90653 |
|
21 |
21 |
$0.00 |
| 0124A |
|
57 |
55 |
$0.00 |
| 90480 |
|
35 |
35 |
$0.00 |
| 90694 |
|
30 |
30 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
56 |
55 |
$0.00 |
| 90677 |
|
60 |
38 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
23 |
23 |
$0.00 |
| 0134A |
|
48 |
47 |
$0.00 |