OPTUM PHARMACY 704, INC.
NPI: 1457408536
· SAN ANTONIO, TX 78249
· 333600000X
$2.07M
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
13 |
$28K |
| 2021 |
118 |
$223K |
| 2022 |
238 |
$481K |
| 2023 |
325 |
$662K |
| 2024 |
1,356 |
$676K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0585 |
Injection,onabotulinumtoxina |
1,000 |
975 |
$2.07M |
| J7613 |
Albuterol non-comp unit |
15 |
15 |
$4.38 |
| J7620 |
Albuterol ipratrop non-comp |
17 |
17 |
$0.10 |
| A4259 |
Lancets per box |
325 |
318 |
$0.00 |
| A9277 |
External transmitter, cgm |
34 |
31 |
$0.00 |
| A4253 |
Blood glucose/reagent strips |
534 |
526 |
$0.00 |
| A9276 |
Disposable sensor, cgm sys |
81 |
79 |
$0.00 |
| E0607 |
Blood glucose monitor home |
44 |
44 |
$0.00 |