NEW JERSEY CVS PHARMACY LLC
NPI: 1144312612
· PASSAIC, NJ 07055
· 332B00000X
$203.75
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
53 |
$50.82 |
| 2021 |
318 |
$152.93 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0001A |
|
228 |
228 |
$118.58 |
| 0002A |
|
143 |
142 |
$85.17 |