WAL-MART STORES EAST LP
NPI: 1821015975
· JANESVILLE, WI 53546
· 332B00000X
$457.92
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
36 |
$457.92 |
| 2022 |
30 |
$0.00 |
| 2023 |
13 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0001A |
|
15 |
13 |
$457.92 |
| 91305 |
|
12 |
12 |
$0.00 |
| 91300 |
|
21 |
19 |
$0.00 |
| 90750 |
|
18 |
15 |
$0.00 |
| 90679 |
|
13 |
13 |
$0.00 |