LONGS DRUG STORES CALIFORNIA LLC

NPI: 1972546737 · HONOLULU, HI 96825 · Pharmacy · NPI assigned 06/13/2006

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

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

$26K

Total Medicaid Paid

880

Total Claims

859

Beneficiaries

Codes Billed

2020-09

First Month

2024-10

Last Month

Provider Details

Authorized Official	COLBERT, SUSAN (DIRECTOR PAYER RELATIONS)
NPI Enumeration Date	06/13/2006

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
91320		41	41	$4K
91322		34	34	$4K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	341	326	$4K
0064A		92	92	$4K
90480		79	79	$3K
0134A		50	50	$2K
90686		108	102	$2K
0012A		41	41	$2K
90674		42	42	$1K
0011A		19	19	$611.52
90661		15	15	$488.74
90656		18	18	$178.80