NEW JERSEY CVS PHARMACY LLC
NPI: 1700978434
· ROSELLE, NJ 07203
· Community/Retail Pharmacy
$80.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
28 |
$80.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0012A |
|
14 |
14 |
$80.00 |
| 0011A |
|
14 |
14 |
$0.00 |