WAL-MART STORES EAST, LP
NPI: 1922181023
· BELOIT, WI 53511
· 156FX1800X
$744.58
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
27 |
$353.58 |
| 2023 |
24 |
$391.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
36 |
36 |
$605.00 |
| 92015 |
|
15 |
14 |
$139.58 |