WAL-MART STORES EAST LP
NPI: 1689015356
· MOUNT PLEASANT, WI 53406
· Durable Medical Equipment & Medical Supplies
$534.24
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
63 |
$534.24 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0004A |
|
19 |
19 |
$534.24 |
| 91300 |
|
30 |
28 |
$0.00 |
| 91303 |
|
14 |
13 |
$0.00 |