WAL-MART STORES EAST LP
NPI: 1821015199
· PRESQUE ISLE, ME 04769
· Pharmacy
· NPI assigned 07/16/2006
Billing Flags
· Automated signals — not evidence of fraud
Entity Proliferation
Authorized official CANONIC, KIMBERLY controls 20+ related entities in our dataset. Read more
$46.59
Total Medicaid Paid
Provider Details
| Authorized Official | CANONIC, KIMBERLY (SENIOR DIRECTOR, ENROLLMENT) |
| NPI Enumeration Date | 07/16/2006 |
Related Entities
Other providers sharing the same authorized official: CANONIC, KIMBERLY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
151 |
$46.59 |
| 2019 |
121 |
$0.00 |
| 2020 |
90 |
$0.00 |
| 2021 |
565 |
$0.00 |
| 2022 |
60 |
$0.00 |
| 2023 |
14 |
$0.00 |
| 2024 |
39 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
12 |
12 |
$46.59 |
| 90480 |
|
14 |
14 |
$0.00 |
| 90686 |
|
27 |
27 |
$0.00 |
| 0011A |
|
112 |
110 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
326 |
325 |
$0.00 |
| 0064A |
|
81 |
81 |
$0.00 |
| 0012A |
|
113 |
113 |
$0.00 |
| 0001A |
|
38 |
38 |
$0.00 |
| 90662 |
|
180 |
179 |
$0.00 |
| 0002A |
|
12 |
12 |
$0.00 |
| 0004A |
|
91 |
91 |
$0.00 |
| 90682 |
|
12 |
12 |
$0.00 |
| 0003A |
|
22 |
22 |
$0.00 |