WAL-MART STORES EAST LP
NPI: 1497772701
· PALATKA, FL 32177
· 333600000X
$160.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
199 |
$160.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0012A |
|
80 |
69 |
$80.00 |
| 0064A |
|
45 |
40 |
$40.00 |
| 0011A |
|
74 |
65 |
$40.00 |