WAL-MART STORES EAST LP

NPI: 1992163372 · FAYETTEVILLE, NC 28306 · Durable Medical Equipment & Medical Supplies · NPI assigned 02/01/2016

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official CANONIC, KIMBERLY controls 20+ related entities in our dataset. Read more

$6K

Total Medicaid Paid

553

Total Claims

451

Beneficiaries

Codes Billed

2018-03

First Month

2021-12

Last Month

Provider Details

Authorized Official	CANONIC, KIMBERLY (SENIOR DIRECTOR, ENROLLMENT)
NPI Enumeration Date	02/01/2016

Other providers sharing the same authorized official: CANONIC, KIMBERLY

Provider	City	State	Total Paid
WALMART INC.	INDEPENDENCE	IA	$7K
WALMART INC.	ANKENY	IA	$3K
WALMART INC.	WINDSOR HEIGHTS	IA	$2K
WALMART INC.	IOWA CITY	IA	$2K
WALMART INC.	CENTERVILLE	IA	$2K
WALMART INC.	DENISON	IA	$2K
WALMART INC.	WEST BURLINGTON	IA	$1K
WALMART INC.	MONTICELLO	AR	$1K
WALMART INC.	MASON CITY	IA	$919.50
WAL-MART STORES EAST LP	KENDALL	FL	$301.97
WALMART INC.	WASECA	MN	$242.86
WAL-MART STORES EAST LP	HIALEAH	FL	$160.00
WALMART INC.	BROOKLYN PARK	MN	$81.46
WAL-MART STORES EAST LP	EVANSVILLE	IN	$74.87
WALMART INC.	PINE CITY	MN	$63.44
WALMART INC.	ANAMOSA	IA	$41.46
WAL-MART STORES EAST LP	JACKSONVILLE	FL	$28.39
WALMART INC.	SHENANDOAH	IA	$22.95
WAL-MART STORES EAST LP	OCALA	FL	$1.12
WALMART INC.	FAYETTEVILLE	AR	$0.07

Year	Claims	Total Paid
2018	172	$172.70
2021	381	$6K

Code	Description	Claims	Beneficiaries	Total Paid
0012A		68	67	$3K
0031A		27	26	$2K
0001A		51	51	$1K
0002A		22	22	$585.00
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	115	52	$137.22
90686		29	16	$35.48
91300		105	96	$0.00
90746		28	15	$0.00
91307		13	12	$0.00
91303		13	13	$0.00
91301		82	81	$0.00