KANSAS CVS PHARMACY LLC
NPI: 1093974529
· SHAWNEE, KS 66226
· 332B00000X
$12.95
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
255 |
$12.95 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0004A |
|
42 |
42 |
$12.95 |
| 0001A |
|
104 |
96 |
$0.00 |
| 0002A |
|
109 |
109 |
$0.00 |