WAL-MART STORES EAST, LP
NPI: 1346268042
· STROUGHTON, WI 53589
· 332B00000X
$567.47
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
48 |
$567.47 |
| 2023 |
23 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90686 |
|
22 |
17 |
$567.47 |
| 91305 |
|
12 |
12 |
$0.00 |
| 90750 |
|
14 |
13 |
$0.00 |
| 90679 |
|
23 |
23 |
$0.00 |