Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

WISCONSIN CVS PHARMACY LLC

NPI: 1053494369 · WEST ALLIS, WI 53227 · 3336C0003X

$8K

Total Medicaid Paid

934

Total Claims

518

Beneficiaries

8

Codes Billed

2018-09

First Month

2023-11

Last Month

Monthly Spending Trend

Yearly Breakdown

Year	Claims	Total Paid
2018	79	$781.79
2019	74	$2K
2020	135	$4K
2021	53	$1K
2022	581	$285.75
2023	12	$0.00

Billing Codes

Code	Description	Claims	Beneficiaries	Total Paid
90686		177	144	$3K
90674		85	68	$2K
90662		43	43	$1K
90688		42	42	$1K
90682		14	14	$694.21
91300		493	163	$0.00
91307		68	32	$0.00
91318		12	12	$0.00