Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › PR › SABANA GRANDE › FARMACIA SAGRADO, INC.

FARMACIA SAGRADO, INC.

NPI: 1952653776 · SABANA GRANDE, PR 00637 · Compounding Pharmacy · NPI assigned 10/03/2012

$24K
Total Medicaid Paid
706
Total Claims
436
Beneficiaries
4
Codes Billed
2018-02
First Month
2019-12
Last Month

Provider Details

Authorized OfficialMIRANDA, ILIANETTE (PRESIDENT)
NPI Enumeration Date10/03/2012

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 514 $23K
2019 192 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
90670 117 62 $21K
90686 195 124 $4K
G0008 Administration of influenza virus vaccine 197 125 $0.00
G0009 Administration of pneumococcal vaccine 197 125 $0.00