WAL-MART STORES EAST LP
NPI: 1992722060
· BELOIT, WI 53511
· 332B00000X
$457.91
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
17 |
$457.91 |
| 2023 |
14 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90686 |
|
17 |
14 |
$457.91 |
| 90679 |
|
14 |
14 |
$0.00 |