WAL-MART STORES EAST LP
NPI: 1710904883
· MARINETTE, WI 54143
· 332B00000X
$373.23
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
13 |
$337.23 |
| 2021 |
65 |
$36.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90686 |
|
13 |
13 |
$337.23 |
| 0011A |
|
15 |
15 |
$36.00 |
| 91301 |
|
50 |
49 |
$0.00 |