WAL-MART STORES EAST LP
NPI: 1073530325
· THIBODAUX, LA 70301
· Durable Medical Equipment & Medical Supplies
· NPI assigned 07/16/2006
Billing Flags
· Automated signals — not evidence of fraud
Entity Proliferation
Authorized official CANONIC, KIMBERLY controls 20+ related entities in our dataset. Read more
$40.00
Total Medicaid Paid
Provider Details
| Authorized Official | CANONIC, KIMBERLY (SENIOR DIRECTOR, ENROLLMENT) |
| NPI Enumeration Date | 07/16/2006 |
Related Entities
Other providers sharing the same authorized official: CANONIC, KIMBERLY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
429 |
$40.00 |
| 2022 |
14 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0064A |
|
93 |
93 |
$40.00 |
| 0004A |
|
15 |
15 |
$0.00 |
| 0002A |
|
15 |
15 |
$0.00 |
| 0001A |
|
51 |
50 |
$0.00 |
| 0011A |
|
148 |
130 |
$0.00 |
| 0012A |
|
94 |
94 |
$0.00 |
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
14 |
14 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
13 |
13 |
$0.00 |