WAL-MART STORES EAST LP
NPI: 1871510081
· LEESBURG, FL 34748
· 333600000X
$200.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
89 |
$200.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0001A |
|
34 |
29 |
$120.00 |
| 0002A |
|
21 |
19 |
$80.00 |
| 0004A |
|
34 |
31 |
$0.00 |