BROULIM SUPERMARKETS, LLC
Community/Retail Pharmacy · SAINT ANTHONY, ID
Organization Active NPI 1669935813
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 44 | 144 | $10,904 | $10,479 | $10,479 |
| 2023 | 57 | 155 | $11,867 | $11,042 | $11,042 |
| 2022 | 92 | 182 | $13,420 | $7,291 | $7,291 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 36 | $27 | $27 |
| 90480 | Admn sarscov2 vacc 1 dose | 34 | $28 | $28 |
| 90662 | Influenza vaccine split virus, preservative free | 33 | $82 | $82 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 30 | $153 | $153 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | ✓ | — | — |
| Pharmacy | 333600000X | — | — | |
| Clinic Pharmacy | 3336C0002X | — | — |
Other Community/Retail Pharmacy providers in Idaho
- NPI 1194736694
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- NPI 1164293601
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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.