YODORINCMISSIONPLAZAPHARMACY
NPI: 1184688921
· MISSION, TX 78572
· Pharmacist
· NPI assigned 04/17/2006
$274.99
Total Medicaid Paid
Provider Details
| Authorized Official | ESPINOZA, DORA (VP, SECRETARY, PHARMACIST) |
| NPI Enumeration Date | 04/17/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
49 |
$131.86 |
| 2019 |
25 |
$143.13 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
62 |
62 |
$269.63 |
| A4259 |
Lancets, per box of 100 |
12 |
12 |
$5.36 |