ROUNDYS SUPERMARKETS INC
NPI: 1609103605
· WISCONSIN RAPIDS, WI 54494
· 3336C0003X
$971.60
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
17 |
$0.00 |
| 2019 |
28 |
$0.00 |
| 2020 |
46 |
$0.00 |
| 2021 |
49 |
$486.70 |
| 2023 |
27 |
$0.00 |
| 2024 |
13 |
$484.90 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90480 |
|
13 |
13 |
$484.90 |
| 90686 |
|
109 |
109 |
$376.50 |
| 0002A |
|
16 |
16 |
$76.32 |
| 0001A |
|
15 |
15 |
$33.88 |
| 90678 |
|
27 |
27 |
$0.00 |