WAL-MART STORES EAST LP
NPI: 1902824709
· ELIZABETH CITY, NC 27909
· 332B00000X
$780.00
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
115 |
$780.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0001A |
|
29 |
29 |
$520.00 |
| 0002A |
|
14 |
14 |
$195.00 |
| 0012A |
|
12 |
12 |
$65.00 |
| 91300 |
|
45 |
45 |
$0.00 |
| 91301 |
|
15 |
15 |
$0.00 |