WAL-MART STORES EAST LP
NPI: 1013934314
· CORYDON, IN 47112
· 332B00000X
$456.02
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
59 |
$94.85 |
| 2019 |
70 |
$332.88 |
| 2021 |
107 |
$28.29 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose/reagent strips |
143 |
137 |
$456.02 |
| 0064A |
|
69 |
68 |
$0.00 |
| 0012A |
|
12 |
12 |
$0.00 |
| 0031A |
|
12 |
12 |
$0.00 |