BROULIM SUPERMARKETS, LLC
Community/Retail Pharmacy · AMMON, ID
Organization Active NPI 1336517861
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 179 | 530 | $37,938 | $36,640 | $36,640 |
| 2023 | 157 | 412 | $25,341 | $23,590 | $23,590 |
| 2022 | 268 | 612 | $43,525 | $25,207 | $25,207 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 147 | $25 | $25 |
| 90662 | Influenza vaccine split virus, preservative free | 116 | $82 | $82 |
| 90480 | Admn sarscov2 vacc 1 dose | 106 | $27 | $27 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 97 | $153 | $153 |
| 90656 | Influenza vaccine, trivalent, split virus, preservative-free, 0.5 ml dosage | 26 | $22 | $22 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 12 | $288 | $288 |
| G0009 | Administration of pneumococcal vaccine | 12 | $30 | $30 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | ✓ | — | — |
| Primary Care Clinic/Center | 261QP2300X | — | — | |
| Pharmacy | 333600000X | — | — | |
| Clinic Pharmacy | 3336C0002X | — | — |
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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.