WAL-MART STORES EAST LP
NPI: 1295042257
· SOMERDALE, NJ 08083
· Durable Medical Equipment & Medical Supplies
$96.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
45 |
$96.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0012A |
|
22 |
22 |
$56.00 |
| 0011A |
|
23 |
19 |
$40.00 |