Supplier
Farmacia Sagrado, INC.
Farmacia Sagrado, INC. was paid $24K by Medicaid between Feb 2018 and Dec 2019, across 4 billing codes. Its largest line is 90670, — 85% of everything it billed.
33Billing provider infoFARMACIA SAGRADO, INC.
SABANA GRANDE, PR 00637
SABANA GRANDE, PR 00637
33aNPI1952653776assigned 10/03/2012
33bProvider typeCompounding Pharmacy
28Total paid$24K
24GClaims706
24DCodes billed4
24AFirst – last monthFeb 2018 – Dec 2019
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 514 | $23K | |
| 2019 | 192 | $1K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 90670 | 85% | 117 | 62 | $21K | |
| 90686 | 15% | 195 | 124 | $4K | |
| G0008 | Administration of influenza virus vaccine | 0% | 197 | 125 | $0.00 |
| G0009 | Administration of pneumococcal vaccine | 0% | 197 | 125 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialMIRANDA, ILIANETTE (PRESIDENT)