FAMILIA CORTES-LEBRON
NPI: 1164537395
· LAJAS, PR 00667
· Community/Retail Pharmacy
· NPI assigned 08/20/2006
$956.89
Total Medicaid Paid
Provider Details
| Authorized Official | LEBRON, MARISOL (VICE-PRESIDENT) |
| NPI Enumeration Date | 08/20/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
50 |
$342.51 |
| 2019 |
42 |
$228.36 |
| 2020 |
126 |
$366.02 |
| 2022 |
88 |
$20.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90686 |
|
142 |
138 |
$936.89 |
| G0008 |
Administration of influenza virus vaccine |
164 |
154 |
$20.00 |