WALMART INC.

NPI: 1720005077 · HILO, HI 96720 · Durable Medical Equipment & Medical Supplies · NPI assigned 07/16/2006

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official CANONIC, KIMBERLY controls 20+ related entities in our dataset. Read more

$37K

Total Medicaid Paid

1,570

Total Claims

1,549

Beneficiaries

Codes Billed

2018-01

First Month

2024-11

Last Month

Provider Details

Authorized Official	CANONIC, KIMBERLY (SENIOR DIRECTOR, ENROLLMENT)
NPI Enumeration Date	07/16/2006

Other providers sharing the same authorized official: CANONIC, KIMBERLY

Provider	City	State	Total Paid
WALMART INC.	INDEPENDENCE	IA	$7K
WALMART INC.	ANKENY	IA	$3K
WALMART INC.	WINDSOR HEIGHTS	IA	$2K
WALMART INC.	IOWA CITY	IA	$2K
WALMART INC.	CENTERVILLE	IA	$2K
WALMART INC.	DENISON	IA	$2K
WALMART INC.	WEST BURLINGTON	IA	$1K
WALMART INC.	MONTICELLO	AR	$1K
WALMART INC.	MASON CITY	IA	$919.50
WAL-MART STORES EAST LP	KENDALL	FL	$301.97
WALMART INC.	WASECA	MN	$242.86
WAL-MART STORES EAST LP	HIALEAH	FL	$160.00
WALMART INC.	BROOKLYN PARK	MN	$81.46
WAL-MART STORES EAST LP	EVANSVILLE	IN	$74.87
WALMART INC.	PINE CITY	MN	$63.44
WALMART INC.	ANAMOSA	IA	$41.46
WAL-MART STORES EAST LP	JACKSONVILLE	FL	$28.39
WALMART INC.	SHENANDOAH	IA	$22.95
WAL-MART STORES EAST LP	OCALA	FL	$1.12
WALMART INC.	FAYETTEVILLE	AR	$0.07

Code	Description	Claims	Beneficiaries	Total Paid
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	558	543	$6K
0071A		129	129	$5K
0072A		109	109	$4K
0064A		103	103	$3K
90686		182	182	$3K
0012A		78	78	$3K
0031A		79	79	$2K
0011A		76	76	$2K
90682		32	32	$2K
0124A		50	50	$2K
91322		23	23	$2K
90656		67	67	$1K
90480		36	36	$1K
0054A		13	13	$440.00
90472	Immunization administration, each additional vaccine (list separately)	35	29	$137.04