WAL-MART STORES EAST LP
NPI: 1700803871
· APPLETON, WI 54915
· 332B00000X
$440.22
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
27 |
$440.22 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0012A |
|
13 |
13 |
$440.22 |
| 91301 |
|
14 |
14 |
$0.00 |