WAL-MART STORES EAST LP
NPI: 1912924283
· AUBURN, ME 04210
· 332B00000X
$274.54
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
141 |
$274.54 |
| 2019 |
74 |
$0.00 |
| 2020 |
34 |
$0.00 |
| 2021 |
828 |
$0.00 |
| 2022 |
123 |
$0.00 |
| 2023 |
12 |
$0.00 |
| 2024 |
38 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose/reagent strips |
62 |
58 |
$274.54 |
| 90662 |
|
113 |
113 |
$0.00 |
| 0004A |
|
72 |
72 |
$0.00 |
| 0124A |
|
29 |
29 |
$0.00 |
| 0002A |
|
36 |
36 |
$0.00 |
| G0008 |
Admin influenza virus vac |
264 |
264 |
$0.00 |
| 0064A |
|
191 |
191 |
$0.00 |
| 0012A |
|
200 |
200 |
$0.00 |
| 0001A |
|
57 |
57 |
$0.00 |
| K1034 |
Covid test self-admn/collect |
13 |
12 |
$0.00 |
| 0011A |
|
201 |
201 |
$0.00 |
| 90480 |
|
12 |
12 |
$0.00 |