WAL-MART STORES EAST LP
NPI: 1376560649
· HOULTON, ME 04730
· 332B00000X
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
293 |
$859.59 |
| 2019 |
257 |
$790.93 |
| 2020 |
237 |
$703.93 |
| 2021 |
439 |
$226.27 |
| 2022 |
43 |
$0.00 |
| 2023 |
14 |
$0.00 |
| 2024 |
59 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose/reagent strips |
623 |
605 |
$3K |
| A4259 |
Lancets per box |
37 |
37 |
$14.72 |
| 90662 |
|
114 |
114 |
$0.00 |
| 91322 |
|
14 |
14 |
$0.00 |
| 0012A |
|
104 |
97 |
$0.00 |
| G0008 |
Admin influenza virus vac |
225 |
225 |
$0.00 |
| 0011A |
|
104 |
100 |
$0.00 |
| 0064A |
|
103 |
103 |
$0.00 |
| 90480 |
|
18 |
18 |
$0.00 |