WAL-MART STORES EAST LP
NPI: 1669490173
· CALAIS, ME 04619
· 332B00000X
$702.69
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
122 |
$230.10 |
| 2019 |
154 |
$202.98 |
| 2020 |
172 |
$173.10 |
| 2021 |
449 |
$96.51 |
| 2022 |
84 |
$0.00 |
| 2023 |
50 |
$0.00 |
| 2024 |
89 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose/reagent strips |
114 |
114 |
$702.69 |
| G0008 |
Admin influenza virus vac |
354 |
353 |
$0.00 |
| 90686 |
|
12 |
12 |
$0.00 |
| 0064A |
|
151 |
151 |
$0.00 |
| 0012A |
|
119 |
119 |
$0.00 |
| 90480 |
|
28 |
28 |
$0.00 |
| 0011A |
|
123 |
123 |
$0.00 |
| 90662 |
|
148 |
147 |
$0.00 |
| 0124A |
|
20 |
20 |
$0.00 |
| 90682 |
|
25 |
25 |
$0.00 |
| 0004A |
|
13 |
13 |
$0.00 |
| 91322 |
|
13 |
13 |
$0.00 |