WAL-MART STORES EAST LP
NPI: 1396762761
· HAMMOND, IN 46324
· 332B00000X
$189.72
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
12 |
$0.00 |
| 2019 |
13 |
$23.31 |
| 2020 |
30 |
$166.41 |
| 2021 |
78 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose/reagent strips |
55 |
55 |
$189.72 |
| 0011A |
|
17 |
17 |
$0.00 |
| 0064A |
|
36 |
36 |
$0.00 |
| 0012A |
|
25 |
25 |
$0.00 |