BROULIM SUPERMARKETS, LLC
Community/Retail Pharmacy · AMMON, ID
Organization Active NPI 1851854095
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 86 | 282 | $19,657 | $18,895 | $18,895 |
| 2023 | 112 | 329 | $23,704 | $22,815 | $22,815 |
| 2022 | 186 | 431 | $31,831 | $19,876 | $19,876 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 79 | $25 | $25 |
| 90480 | Admn sarscov2 vacc 1 dose | 54 | $27 | $27 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 51 | $153 | $153 |
| 90662 | Influenza vaccine split virus, preservative free | 49 | $82 | $82 |
| 90656 | Influenza vaccine, trivalent, split virus, preservative-free, 0.5 ml dosage | 22 | $22 | $22 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | ✓ | — | — |
| Primary Care Clinic/Center | 261QP2300X | — | — | |
| Pharmacy | 333600000X | — | — | |
| Clinic Pharmacy | 3336C0002X | — | — |
Other Community/Retail Pharmacy providers in Idaho
- NPI 1922055383
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- NPI 1174371835
- NPI 1154192946
Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.