PROVERI RX LLC
NPI: 1457913808
· STOCKTON, CA 95207
· Long Term Care Pharmacy
· NPI assigned 07/06/2019
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | TRAN, DAVIS (MANAGER) |
| NPI Enumeration Date | 07/06/2019 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
26 |
$0.00 |
| 2024 |
49 |
$0.00 |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 90480 |
|
29 |
29 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
17 |
17 |
$0.00 |
| 91322 |
|
29 |
29 |
$0.00 |