FARMACIA BELMONTE DEL OESTE INC
NPI: 1578980215
· ANASCO, PR 00610
· Pharmacy
· NPI assigned 03/19/2014
$302.10
Total Medicaid Paid
Provider Details
| Authorized Official | MARTINEZ, DAVID (PRESIDENT) |
| NPI Enumeration Date | 03/19/2014 |
Related Entities
Other providers sharing the same authorized official: MARTINEZ, DAVID
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
41 |
$302.10 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
22 |
20 |
$302.10 |
| 90686 |
|
19 |
19 |
$0.00 |