WAL-MART STORES EAST LP
NPI: 1538186697
· WAUSAU, WI 54401
· 332B00000X
$604.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
16 |
$0.00 |
| 2023 |
77 |
$295.00 |
| 2024 |
12 |
$309.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90679 |
|
64 |
64 |
$604.00 |
| 90750 |
|
41 |
39 |
$0.00 |