BROULIM SUPERMARKETS, LLC
Community/Retail Pharmacy · AFTON, WY
Organization Active NPI 1659615078
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 182 | 532 | $33,080 | $31,798 | $31,798 |
| 2023 | 176 | 441 | $26,296 | $24,360 | $24,360 |
| 2022 | 341 | 790 | $44,487 | $31,317 | $31,317 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 171 | $25 | $25 |
| 90662 | Influenza vaccine split virus, preservative free | 93 | $82 | $82 |
| 90480 | Admn sarscov2 vacc 1 dose | 87 | $28 | $28 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 74 | $153 | $153 |
| 90656 | Influenza vaccine, trivalent, split virus, preservative-free, 0.5 ml dosage | 71 | $22 | $22 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 13 | $143 | $143 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | ✓ | — | — |
| 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.