BORDER VILLAGE PHARMACY INC
NPI: 1689145120
· EL CAJON, CA 92020
· Community/Retail Pharmacy
· NPI assigned 12/10/2018
$609.49
Total Medicaid Paid
Provider Details
| Authorized Official | DAVYDOV, LEONID (CEO/PIC) |
| NPI Enumeration Date | 12/10/2018 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
81 |
$383.35 |
| 2023 |
71 |
$226.14 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90694 |
|
88 |
88 |
$507.14 |
| G0008 |
Administration of influenza virus vaccine |
48 |
48 |
$69.84 |
| 90756 |
|
16 |
16 |
$32.51 |