CENTRO DE VACUNACION
NPI: 1083993745
· CAGUAS, PR 00725
· Primary Care Clinic/Center
· NPI assigned 08/12/2011
$330K
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: GANDARA, ROBERTO
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
19,212 |
$90K |
| 2019 |
12,689 |
$50K |
| 2020 |
4,035 |
$13K |
| 2021 |
3,810 |
$51K |
| 2022 |
6,587 |
$36K |
| 2023 |
4,508 |
$23K |
| 2024 |
5,319 |
$66K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
20,613 |
9,025 |
$160K |
| 90461 |
|
6,736 |
5,083 |
$75K |
| 0004A |
|
482 |
474 |
$19K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,651 |
1,408 |
$15K |
| 0001A |
|
477 |
460 |
$15K |
| 0002A |
|
367 |
362 |
$14K |
| 0071A |
|
317 |
315 |
$12K |
| 0072A |
|
269 |
269 |
$10K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
434 |
310 |
$3K |
| 90670 |
|
2,262 |
2,135 |
$1K |
| 91307 |
|
572 |
520 |
$1K |
| 90681 |
|
1,163 |
1,083 |
$852.00 |
| 90686 |
|
2,630 |
2,323 |
$695.02 |
| 90651 |
|
2,027 |
1,940 |
$505.37 |
| 90744 |
|
865 |
772 |
$489.01 |
| 90716 |
|
1,525 |
1,445 |
$275.00 |
| 90707 |
|
1,434 |
1,363 |
$270.00 |
| 90633 |
|
2,312 |
2,197 |
$238.00 |
| 90734 |
|
1,475 |
1,433 |
$150.00 |
| 90698 |
|
1,177 |
1,113 |
$132.63 |
| 90715 |
|
1,289 |
1,118 |
$131.00 |
| 90723 |
|
621 |
587 |
$95.00 |
| 90620 |
|
774 |
745 |
$90.00 |
| 90648 |
|
1,164 |
1,058 |
$78.00 |
| 90621 |
|
192 |
191 |
$48.00 |
| 90696 |
|
364 |
358 |
$42.00 |
| 90700 |
|
331 |
270 |
$6.00 |
| 90685 |
|
318 |
300 |
$6.00 |
| 90677 |
|
476 |
375 |
$0.00 |
| 90732 |
|
51 |
49 |
$0.00 |
| 90697 |
|
174 |
172 |
$0.00 |
| 90619 |
|
34 |
33 |
$0.00 |
| 90480 |
|
17 |
17 |
$0.00 |
| 91320 |
|
15 |
15 |
$0.00 |
| 91300 |
|
1,441 |
1,341 |
$0.00 |
| 90671 |
|
99 |
99 |
$0.00 |
| 90713 |
|
12 |
12 |
$0.00 |