WAL-MART STORES EAST LP
NPI: 1770500985
· WINTER HAVEN, FL 33880
· 332B00000X
$80.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
121 |
$80.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0011A |
|
56 |
53 |
$80.00 |
| 0012A |
|
46 |
44 |
$0.00 |
| 0064A |
|
19 |
18 |
$0.00 |