FREDERICK RAY PHARMACY LLC
NPI: 1487298782
· MOODUS, CT 06469
· Pharmacy
· NPI assigned 10/30/2019
Provider Details
| Authorized Official | TAVARES, DANIEL (PHARMACY MANAGER) |
| NPI Enumeration Date | 10/30/2019 |
Related Entities
Other providers sharing the same authorized official: TAVARES, DANIEL
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
896 |
$33K |
| 2021 |
430 |
$8K |
| 2022 |
83 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4927 |
Gloves, non-sterile, per 100 |
1,292 |
1,207 |
$25K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
117 |
117 |
$17K |