WAL-MART STORES EAST LP
NPI: 1598782971
· CORAL SPRINGS, FL 33067
· 332B00000X
$160.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
95 |
$160.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0001A |
|
30 |
27 |
$80.00 |
| 0004A |
|
48 |
44 |
$80.00 |
| 0002A |
|
17 |
15 |
$0.00 |