WAL-MART STORES EAST LP
NPI: 1750309449
· CROSS LANES, WV 25313
· 332B00000X
$586.20
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
13 |
$586.20 |
| 2021 |
12 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0008 |
Admin influenza virus vac |
13 |
13 |
$586.20 |
| 0011A |
|
12 |
12 |
$0.00 |