ROUNDYS SUPERMARKETS INC
NPI: 1568750545
· GREENFIELD, WI 53220
· Community/Retail Pharmacy
· NPI assigned 07/12/2011
$307.05
Total Medicaid Paid
Provider Details
| Authorized Official | ANDREWS, VICTORIA (MANAGER OF PHARMACY LICENSING) |
| NPI Enumeration Date | 07/12/2011 |
Related Entities
Other providers sharing the same authorized official: ANDREWS, VICTORIA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
12 |
$0.00 |
| 2019 |
17 |
$0.00 |
| 2020 |
15 |
$0.00 |
| 2021 |
15 |
$307.05 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90686 |
|
59 |
59 |
$307.05 |