WAL-MART STORES EAST LP
NPI: 1306245733
· GOLDSBORO, NC 27534
· 332B00000X
$325.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
29 |
$325.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0011A |
|
12 |
12 |
$325.00 |
| 91301 |
|
17 |
17 |
$0.00 |