WAL-MART STORES EAST LP
NPI: 1710904875
· RHINELANDER, WI 54501
· 332B00000X
$794.16
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
18 |
$430.95 |
| 2020 |
13 |
$363.21 |
| 2022 |
16 |
$0.00 |
| 2023 |
18 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90686 |
|
31 |
25 |
$794.16 |
| 90750 |
|
16 |
13 |
$0.00 |
| 90679 |
|
18 |
18 |
$0.00 |