WAL-MART STORES EAST LP
NPI: 1356368401
· WATERTOWN, WI 53094
· 332B00000X
$474.86
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
28 |
$474.86 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0001A |
|
14 |
14 |
$474.86 |
| 91300 |
|
14 |
13 |
$0.00 |