WAL-MART STORES EAST LP

NPI: 1477570620 · WILKESBORO, NC 28697 · Durable Medical Equipment & Medical Supplies · NPI assigned 07/16/2006

$5K

Total Medicaid Paid

380

Total Claims

337

Beneficiaries

Codes Billed

2021-05

First Month

2021-12

Last Month

Provider Details

Authorized Official	LITTLE, SARAH (DIRECTOR OF HEALTHCARE CONTRACTING)
NPI Enumeration Date	07/16/2006

Other providers sharing the same authorized official: LITTLE, SARAH

Provider	City	State	Total Paid
WAL-MART STORES EAST LP	TAMPA	FL	$6K
WALMART INC.	OTTUMWA	IA	$3K
WALMART INC.	BOONE	IA	$2K
WALMART INC.	CRESTON	IA	$2K
WALMART INC.	INDIANOLA	IA	$2K
WALMART INC.	KEOKUK	IA	$767.57
WALMART INC.	FOREST LAKE	MN	$692.41
WALMART INC.	WATERLOO	IA	$590.29
WALMART INC.	MANCHESTER	IA	$440.00
WALMART INC.	MAQUOKETA	IA	$404.34
WAL-MART STORES EAST LP	MIRAMAR	FL	$216.94
WAL-MART STORES EAST LP	LEESBURG	FL	$200.00
WAL-MART STORES EAST LP	HAMMOND	IN	$189.72
WALMART INC.	OWATONNA	MN	$162.92
WAL-MART STORES EAST LP	CORAL SPRINGS	FL	$160.00
WALMART INC.	STORM LAKE	IA	$156.11
WAL-MART STORES EAST LP	TALLAHASSEE	FL	$155.52
WAL-MART STORES EAST LP	SEBRING	FL	$120.00
WAL-MART STORES EAST LP	GREENACRES	FL	$120.00
WAL-MART STORES EAST LP	JACKSONVILLE	FL	$96.94

Year	Claims	Total Paid
2021	380	$5K

Code	Claims	Beneficiaries	Total Paid
0002A	105	96	$3K
0001A	48	46	$910.00
0012A	15	12	$845.00
91301	15	12	$0.00
91300	197	171	$0.00