WAL-MART STORES EAST, LP
NPI: 1043391055
· BRISTOL, CT 06010
· 156FX1800X
$156K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
3,344 |
$17K |
| 2019 |
2,580 |
$39K |
| 2020 |
989 |
$21K |
| 2021 |
1,941 |
$26K |
| 2022 |
1,225 |
$14K |
| 2023 |
2,265 |
$21K |
| 2024 |
1,576 |
$17K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
8,854 |
5,559 |
$98K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
4,310 |
2,779 |
$50K |
| V2100 |
Lens spher single plano 4.00 |
522 |
364 |
$5K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
141 |
106 |
$2K |
| V2750 |
Anti-reflective coating |
39 |
37 |
$0.00 |
| V2781 |
Progressive lens per lens |
54 |
36 |
$0.00 |