WAL-MART STORES EAST LP
NPI: 1861410524
· NORTH BRUNSWICK, NJ 08902
· 332B00000X
$162.94
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
384 |
$162.94 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0012A |
|
162 |
162 |
$112.00 |
| 0011A |
|
190 |
189 |
$50.94 |
| 0064A |
|
32 |
32 |
$0.00 |