WAL-MART STORES EAST LP
NPI: 1700010170
· WOODBURY, NJ 08096
· 332B00000X
$28.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
15 |
$28.00 |
| 2022 |
77 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0012A |
|
15 |
14 |
$28.00 |
| 90686 |
|
23 |
23 |
$0.00 |
| G0008 |
Admin influenza virus vac |
31 |
31 |
$0.00 |
| 0124A |
|
23 |
23 |
$0.00 |