WAL-MART STORES EAST LP
NPI: 1275550477
· SPARTA, TN 38583
· 332B00000X
$195.56
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
69 |
$60.34 |
| 2019 |
14 |
$135.22 |
| 2023 |
14 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose/reagent strips |
83 |
83 |
$195.56 |
| 90662 |
|
14 |
12 |
$0.00 |