WISCONSIN CVS PHARMACY LLC
NPI: 1205073681
· SUN PRAIRIE, WI 53590
· 332B00000X
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
30 |
$255.75 |
| 2021 |
155 |
$3K |
| 2023 |
14 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 91322 |
|
14 |
13 |
$1K |
| 0011A |
|
53 |
27 |
$992.16 |
| 0002A |
|
32 |
16 |
$610.56 |
| 90686 |
|
44 |
27 |
$499.65 |
| 0001A |
|
30 |
15 |
$496.08 |
| 0012A |
|
26 |
13 |
$496.08 |