WAL-MART STORES EAST LP
Community/Retail Pharmacy · FOND DU LAC, WI
Organization Active NPI 1710904867
Medicare payment data Part B · 2024
| Year | Beneficiaries | Services | Submitted | Allowed | Paid |
|---|---|---|---|---|---|
| 2024 | 179 | 568 | $40,364 | $39,446 | $39,446 |
| 2023 | 268 | 971 | $57,944 | $56,386 | $56,386 |
| 2022 | 360 | 1,275 | $33,886 | $32,839 | $32,839 |
Top procedures (2024)
| HCPCS | Description | Services | Avg allowed | Avg paid |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 150 | $21 | $21 |
| 90662 | Influenza vaccine split virus, preservative free | 144 | $82 | $82 |
| 90480 | Admn sarscov2 vacc 1 dose | 119 | $11 | $11 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 81 | $156 | $156 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 38 | $150 | $150 |
| G0009 | Administration of pneumococcal vaccine | 15 | $19 | $19 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 14 | $291 | $291 |
Taxonomy & licensure
| Specialty | Code | Primary | License | State |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | ✓ | 8147-42 | WI |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — | |
| Pharmacy | 333600000X | — | — | |
| Specialty Pharmacy | 3336S0011X | — | — |
Other Community/Retail Pharmacy providers in Wisconsin
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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.