WAL-MART STORES EAST LP
NPI: 1144247487
· JENNINGS, LA 70546
· Pharmacy
· 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
$0.00
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 |
|---|
| 2019 |
12 |
$0.00 |
| 2020 |
15 |
$0.00 |
| 2021 |
266 |
$0.00 |
| 2022 |
43 |
$0.00 |
| 2023 |
12 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0008 |
Administration of influenza virus vaccine |
55 |
55 |
$0.00 |
| 0011A |
|
77 |
69 |
$0.00 |
| 0012A |
|
70 |
70 |
$0.00 |
| 0064A |
|
62 |
62 |
$0.00 |
| 0001A |
|
30 |
30 |
$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 |
| 0124A |
|
13 |
13 |
$0.00 |
| 0004A |
|
15 |
15 |
$0.00 |
| 0002A |
|
12 |
12 |
$0.00 |