WALMART INC.

NPI: 1609893080 · MONTICELLO, AR 71655 · Durable Medical Equipment & Medical Supplies · NPI assigned 07/16/2006

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official CANONIC, KIMBERLY controls 20+ related entities in our dataset. Read more

$1K

Total Medicaid Paid

1,071

Total Claims

1,025

Beneficiaries

Codes Billed

2019-09

First Month

2022-08

Last Month

Provider Details

Authorized Official	CANONIC, KIMBERLY (SENIOR DIRECTOR, ENROLLMENT)
NPI Enumeration Date	07/16/2006

Other providers sharing the same authorized official: CANONIC, KIMBERLY

Provider	City	State	Total Paid
WALMART INC.	INDEPENDENCE	IA	$7K
WALMART INC.	ANKENY	IA	$3K
WALMART INC.	WINDSOR HEIGHTS	IA	$2K
WALMART INC.	IOWA CITY	IA	$2K
WALMART INC.	CENTERVILLE	IA	$2K
WALMART INC.	DENISON	IA	$2K
WALMART INC.	WEST BURLINGTON	IA	$1K
WALMART INC.	MASON CITY	IA	$919.50
WAL-MART STORES EAST LP	KENDALL	FL	$301.97
WALMART INC.	WASECA	MN	$242.86
WAL-MART STORES EAST LP	HIALEAH	FL	$160.00
WALMART INC.	BROOKLYN PARK	MN	$81.46
WAL-MART STORES EAST LP	EVANSVILLE	IN	$74.87
WALMART INC.	PINE CITY	MN	$63.44
WAL-MART STORES EAST LP	LAKELAND	FL	$55.47
WALMART INC.	ANAMOSA	IA	$41.46
WAL-MART STORES EAST LP	JACKSONVILLE	FL	$28.39
WALMART INC.	SHENANDOAH	IA	$22.95
WAL-MART STORES EAST LP	OCALA	FL	$1.12
WALMART INC.	FAYETTEVILLE	AR	$0.07

Code	Description	Claims	Beneficiaries	Total Paid
0072A		22	13	$400.00
0011A		217	217	$287.98
90686		15	15	$242.10
0071A		34	30	$120.00
0064A		117	116	$40.00
91301		237	230	$0.24
91307		77	54	$0.20
91300		14	13	$0.01
0012A		215	215	$0.00
K1034	Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count	67	66	$0.00
G0008	Administration of influenza virus vaccine	56	56	$0.00