NORTHLAND HOMETOWN PHARMACY LLC
NPI: 1427514504
· APPLETON, WI 54911
· 332B00000X
$686.88
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
42 |
$686.88 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0003A |
|
19 |
19 |
$686.88 |
| 91300 |
|
23 |
23 |
$0.00 |