WAL-MART STORES EAST LP
NPI: 1285810614
· MEDFORD, WI 54451
· 332B00000X
$76.32
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
127 |
$76.32 |
| 2023 |
66 |
$0.00 |
| 2024 |
12 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0134A |
|
14 |
14 |
$76.32 |
| 90750 |
|
149 |
142 |
$0.00 |
| 90679 |
|
28 |
28 |
$0.00 |
| 91313 |
|
14 |
14 |
$0.00 |