WALMART INC.

NPI: 1790029494 · COLORADO SPRINGS, CO 80916 · Community/Retail Pharmacy · NPI assigned 11/19/2012

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

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

$30K

Total Medicaid Paid

1,099

Total Claims

928

Beneficiaries

Codes Billed

2018-02

First Month

2024-11

Last Month

Provider Details

Authorized Official	CANONIC, KIMBERLY (SENIOR DIRECTOR, ENROLLMENT)
NPI Enumeration Date	11/19/2012

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
A4253	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	203	170	$7K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	529	411	$7K
E1399	Durable medical equipment, miscellaneous	92	91	$7K
90682		59	51	$3K
91322		15	15	$2K
90480		56	56	$1K
90656		47	42	$894.00
0124A		15	15	$600.00
0064A		16	16	$560.00
0004A		15	15	$520.00
90686		19	18	$355.68
0031A		14	13	$353.56
90472	Immunization administration, each additional vaccine (list separately)	19	15	$172.06