Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › PR › CIDRA › FARMACIA SAN PABLO, INC.

FARMACIA SAN PABLO, INC.

NPI: 1093792202 · CIDRA, PR 00739 · Community/Retail Pharmacy · NPI assigned 12/29/2005

$3K
Total Medicaid Paid
351
Total Claims
217
Beneficiaries
3
Codes Billed
2018-09
First Month
2019-12
Last Month

Provider Details

Authorized OfficialBERRIOS, LOURDES (OWNER)
NPI Enumeration Date12/29/2005

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 218 $1K
2019 133 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
90686 169 102 $3K
G0008 Administration of influenza virus vaccine 169 102 $0.00
G0009 Administration of pneumococcal vaccine 13 13 $0.00