WISCONSIN CVS PHARMACY LLC
NPI: 1255372124
· RACINE, WI 53405
· 3336C0003X
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
28 |
$508.09 |
| 2019 |
12 |
$364.65 |
| 2020 |
65 |
$2K |
| 2021 |
27 |
$693.00 |
| 2022 |
71 |
$476.24 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90662 |
|
50 |
50 |
$1K |
| 90686 |
|
39 |
39 |
$1K |
| 90688 |
|
35 |
34 |
$857.21 |
| 90674 |
|
28 |
14 |
$508.09 |
| 91301 |
|
51 |
28 |
$0.00 |