WAL-MART STORES EAST LP
NPI: 1649628298
· HAMILTON, NJ 08619
· 332B00000X
$571.58
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
212 |
$571.58 |
| 2023 |
28 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0012A |
|
93 |
90 |
$396.00 |
| 0011A |
|
106 |
90 |
$175.58 |
| 90480 |
|
14 |
14 |
$0.00 |
| 0064A |
|
13 |
13 |
$0.00 |
| 91322 |
|
14 |
14 |
$0.00 |