WAL-MART STORES EAST LP
NPI: 1083817829
· BREAUX BRIDGE, LA 70517
· Durable Medical Equipment & Medical Supplies
· NPI assigned 06/08/2007
Billing Flags
· Automated signals — not evidence of fraud
Entity Proliferation
Authorized official CANONIC, KIMBERLY controls 20+ related entities in our dataset. Read more
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | CANONIC, KIMBERLY (SENIOR DIRECTOR, ENROLLMENT) |
| NPI Enumeration Date | 06/08/2007 |
Related Entities
Other providers sharing the same authorized official: CANONIC, KIMBERLY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
18 |
$0.00 |
| 2020 |
44 |
$0.00 |
| 2021 |
551 |
$0.00 |
| 2022 |
41 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0004A |
|
31 |
31 |
$0.00 |
| 0002A |
|
78 |
78 |
$0.00 |
| 90662 |
|
12 |
12 |
$0.00 |
| 0011A |
|
135 |
123 |
$0.00 |
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
29 |
29 |
$0.00 |
| 0001A |
|
63 |
63 |
$0.00 |
| 0012A |
|
116 |
116 |
$0.00 |
| 0064A |
|
112 |
112 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
78 |
78 |
$0.00 |