Supplier
Farmacia San Pablo, INC.
Farmacia San Pablo, INC. was paid $3K by Medicaid between Sep 2018 and Dec 2019, across 3 billing codes. Its largest line is 90686, — 100% of everything it billed.
33Billing provider infoFARMACIA SAN PABLO, INC.
CIDRA, PR 00739
CIDRA, PR 00739
33aNPI1093792202assigned 12/29/2005
33bProvider typeCommunity/Retail Pharmacy
28Total paid$3K
24GClaims351
24DCodes billed3
24AFirst – last monthSep 2018 – Dec 2019
Compared with peers
Next to other Community/Retail Pharmacy providers in Puerto Rico
Rank by total paid#13 of 23
Median peer was paid$3K
This provider vs. median0.9×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 218 | $1K | |
| 2019 | 133 | $1K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 90686 | 100% | 169 | 102 | $3K | |
| G0008 | Administration of influenza virus vaccine | 0% | 169 | 102 | $0.00 |
| G0009 | Administration of pneumococcal vaccine | 0% | 13 | 13 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialBERRIOS, LOURDES (OWNER)