WAL-MART STORES EAST LP
NPI: 1629096318
· RICHLAND CENTER, WI 53581
· 332B00000X
$861.90
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
15 |
$397.80 |
| 2021 |
18 |
$464.10 |
| 2022 |
16 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90686 |
|
33 |
29 |
$861.90 |
| 90750 |
|
16 |
13 |
$0.00 |