FAIRVIEW MTM PHARMA, INC
NPI: 1417306200
· SANTA ANA, CA 92703
· Specialty Pharmacy
· NPI assigned 06/13/2016
Provider Details
| Authorized Official | LE, DENISE (PRESIDENT/CEO/PIC) |
| NPI Enumeration Date | 06/13/2016 |
Related Entities
Other providers sharing the same authorized official: LE, DENISE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
120 |
$364.21 |
| 2021 |
337 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
252 |
251 |
$1K |
| A4259 |
Lancets, per box of 100 |
205 |
205 |
$92.01 |