WAL-MART STORES EAST LP
NPI: 1982621223
· DERIDDER, LA 70634
· Durable Medical Equipment & Medical Supplies
· NPI assigned 07/16/2006
Billing Flags
· Automated signals — not evidence of fraud
Entity Proliferation
Authorized official CANONIC, KIMBERLY controls 20+ related entities in our dataset. Read more
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | CANONIC, KIMBERLY (SENIOR DIRECTOR, ENROLLMENT) |
| NPI Enumeration Date | 07/16/2006 |
Related Entities
Other providers sharing the same authorized official: CANONIC, KIMBERLY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
17 |
$0.00 |
| 2019 |
20 |
$0.00 |
| 2020 |
29 |
$0.00 |
| 2021 |
237 |
$0.00 |
| 2022 |
40 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90662 |
|
13 |
13 |
$0.00 |
| 0011A |
|
119 |
115 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
53 |
53 |
$0.00 |
| 0064A |
|
45 |
45 |
$0.00 |
| 0012A |
|
73 |
73 |
$0.00 |
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
40 |
40 |
$0.00 |