WAL-MART STORES EAST LP
NPI: 1649297912
· BRUNSWICK, ME 04011
· 332B00000X
$58.24
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
44 |
$58.24 |
| 2021 |
415 |
$0.00 |
| 2022 |
40 |
$0.00 |
| 2023 |
15 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose/reagent strips |
13 |
12 |
$58.24 |
| 0003A |
|
12 |
12 |
$0.00 |
| 0004A |
|
121 |
121 |
$0.00 |
| 0124A |
|
12 |
12 |
$0.00 |
| 0012A |
|
92 |
92 |
$0.00 |
| G0008 |
Admin influenza virus vac |
104 |
104 |
$0.00 |
| 0011A |
|
82 |
82 |
$0.00 |
| 0064A |
|
78 |
78 |
$0.00 |