Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › WI › MENOMONEE FALLS › COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC

COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC

NPI: 1730627894 · MENOMONEE FALLS, WI 53051 · Institutional Pharmacy · NPI assigned 02/08/2017

$32K
Total Medicaid Paid
4,586
Total Claims
1,179
Beneficiaries
4
Codes Billed
2018-01
First Month
2019-12
Last Month

Provider Details

Authorized OfficialDRIZD, DALE (PHARMACY DIRECTOR)
NPI Enumeration Date02/08/2017

Related Entities

Other providers sharing the same authorized official: DRIZD, DALE

ProviderCityStateTotal Paid
FROEDTERT HEALTH PHARMACY LLC MILWAUKEE WI $13K
FROEDTERT HEALTH PHARMACY LLC MILWAUKEE WI $5K
FROEDTERT HEALTH PHARMACY LLC MILWAUKEE WI $3K
FROEDTERT HEALTH PHARMACY LLC MILWAUKEE WI $2K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 2,258 $14K
2019 2,328 $18K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
T1999 Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" 3,191 601 $28K
S1015 Iv tubing extension set 1,107 455 $4K
A4216 Sterile water, saline and/or dextrose, diluent/flush, 10 ml 241 97 $337.96
A4450 Tape, non-waterproof, per 18 square inches 47 26 $2.04