WAL-MART STORES EAST LP
NPI: 1336166479
· CHERRY HILL, NJ 08002
· 332B00000X
$40.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
33 |
$40.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0004A |
|
21 |
21 |
$40.00 |
| 0064A |
|
12 |
12 |
$0.00 |