WAL-MART STORES EAST LP
NPI: 1760409981
· RICHMOND, IN 47374
· 332B00000X
$702.05
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
129 |
$216.32 |
| 2019 |
108 |
$409.18 |
| 2020 |
106 |
$76.55 |
| 2021 |
153 |
$0.00 |
| 2022 |
104 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose/reagent strips |
219 |
213 |
$702.05 |
| G0008 |
Admin influenza virus vac |
195 |
184 |
$0.00 |
| 90686 |
|
13 |
12 |
$0.00 |
| K1034 |
Covid test self-admn/collect |
50 |
49 |
$0.00 |
| 0012A |
|
12 |
12 |
$0.00 |
| 0011A |
|
13 |
13 |
$0.00 |
| 0064A |
|
28 |
28 |
$0.00 |
| 90682 |
|
12 |
12 |
$0.00 |
| 90662 |
|
39 |
39 |
$0.00 |
| 0004A |
|
19 |
19 |
$0.00 |