WAL-MART STORES EAST LP
NPI: 1114944337
· FRANKFORT, IN 46041
· Pharmacy
· NPI assigned 07/16/2006
$16.64
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 |
|---|
| 2018 |
13 |
$16.64 |
| 2021 |
50 |
$0.00 |
| 2022 |
42 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
13 |
13 |
$16.64 |
| 0064A |
|
50 |
48 |
$0.00 |
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
42 |
41 |
$0.00 |