WAL-MART STORES TEXAS LLC
NPI: 1740207984
· BROWNWOOD, TX 76801
· 332B00000X
$138.64
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
| 2018 |
42 |
$138.64 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
| A4253 |
Blood glucose/reagent strips |
29 |
29 |
$138.64 |
| G0008 |
Admin influenza virus vac |
13 |
13 |
$0.00 |