WAL-MART STORES EAST LP
NPI: 1306863774
· BROOKSVILLE, FL 34613
· 332B00000X
$78.88
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
125 |
$78.88 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0012A |
|
46 |
42 |
$78.88 |
| 0064A |
|
34 |
31 |
$0.00 |
| 0011A |
|
45 |
41 |
$0.00 |