SUN PHARMACY, INC.
NPI: 1336508308
· SAN JOSE, CA 95122
· Compounding Pharmacy
· NPI assigned 02/18/2016
$159.82
Total Medicaid Paid
Provider Details
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
78 |
$159.82 |
| 2021 |
71 |
$0.00 |
| 2022 |
121 |
$0.00 |
| 2023 |
135 |
$0.00 |
| 2024 |
85 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
29 |
29 |
$159.82 |
| 90694 |
|
114 |
114 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
19 |
19 |
$0.00 |
| 90662 |
|
298 |
298 |
$0.00 |
| 90653 |
|
15 |
15 |
$0.00 |
| 0054A |
|
15 |
15 |
$0.00 |