FRED MEYER STORES INC
NPI: 1063458925
· TIGARD, OR 97223
· Durable Medical Equipment & Medical Supplies
· NPI assigned 06/21/2006
$16.94
Total Medicaid Paid
Provider Details
| Authorized Official | MUENNICH, ALLISON (MANAGER OF PHARMACY LICENSING) |
| NPI Enumeration Date | 06/21/2006 |
Related Entities
Other providers sharing the same authorized official: MUENNICH, ALLISON
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
103 |
$16.94 |
| 2024 |
26 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0011A |
|
52 |
36 |
$16.94 |
| 91320 |
|
13 |
13 |
$0.00 |
| 90480 |
|
13 |
13 |
$0.00 |
| 0012A |
|
51 |
38 |
$0.00 |