WAL-MART STORES EAST LP

NPI: 1225055494 · GASTONIA, NC 28052 · 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

$20K

Total Medicaid Paid

1,416

Total Claims

965

Beneficiaries

Codes Billed

2018-07

First Month

2022-01

Last Month

Provider Details

Authorized Official	CANONIC, KIMBERLY (SENIOR DIRECTOR, ENROLLMENT)
NPI Enumeration Date	07/16/2006

Other providers sharing the same authorized official: CANONIC, KIMBERLY

Provider	City	State	Total Paid
WALMART INC.	INDEPENDENCE	IA	$7K
WALMART INC.	ANKENY	IA	$3K
WALMART INC.	WINDSOR HEIGHTS	IA	$2K
WALMART INC.	IOWA CITY	IA	$2K
WALMART INC.	CENTERVILLE	IA	$2K
WALMART INC.	DENISON	IA	$2K
WALMART INC.	WEST BURLINGTON	IA	$1K
WALMART INC.	MONTICELLO	AR	$1K
WALMART INC.	MASON CITY	IA	$919.50
WAL-MART STORES EAST LP	KENDALL	FL	$301.97
WALMART INC.	WASECA	MN	$242.86
WAL-MART STORES EAST LP	HIALEAH	FL	$160.00
WALMART INC.	BROOKLYN PARK	MN	$81.46
WAL-MART STORES EAST LP	EVANSVILLE	IN	$74.87
WALMART INC.	PINE CITY	MN	$63.44
WALMART INC.	ANAMOSA	IA	$41.46
WAL-MART STORES EAST LP	JACKSONVILLE	FL	$28.39
WALMART INC.	SHENANDOAH	IA	$22.95
WAL-MART STORES EAST LP	OCALA	FL	$1.12
WALMART INC.	FAYETTEVILLE	AR	$0.07

Code	Description	Claims	Beneficiaries	Total Paid
0002A		326	289	$16K
90686		180	102	$2K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	365	150	$1K
90715		52	26	$570.93
0001A		27	27	$325.00
90472	Immunization administration, each additional vaccine (list separately)	49	26	$134.90
90746		38	17	$54.65
90732		27	13	$31.21
91307		13	13	$0.00
91300		339	302	$0.00