WAL-MART STORES EAST LP
NPI: 1427075696
· KERNERSVILLE, NC 27284
· 332B00000X
$910.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
117 |
$910.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0001A |
|
28 |
27 |
$715.00 |
| 0002A |
|
15 |
15 |
$195.00 |
| 91300 |
|
74 |
69 |
$0.00 |