WAL-MART STORES EAST LP
NPI: 1073530325
· THIBODAUX, LA 70301
· 332B00000X
$40.00
Total Medicaid Paid
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 |
Covid test self-admn/collect |
14 |
14 |
$0.00 |
| G0008 |
Admin influenza virus vac |
13 |
13 |
$0.00 |