WAL-MART STORES EAST, LP
NPI: 1053492447
· ELKTON, MD 21921
· 156FX1800X
$274K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
1,076 |
$13K |
| 2021 |
2,266 |
$39K |
| 2022 |
2,618 |
$48K |
| 2023 |
3,476 |
$74K |
| 2024 |
3,095 |
$100K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
4,629 |
4,444 |
$144K |
| 99204 |
|
710 |
694 |
$41K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,715 |
2,584 |
$37K |
| S0620 |
Routine ophthalmological exa |
1,038 |
950 |
$28K |
| V2100 |
Lens spher single plano 4.00 |
1,010 |
959 |
$13K |
| 92310 |
|
161 |
129 |
$3K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
112 |
110 |
$3K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
149 |
143 |
$1K |
| V2784 |
Lens polycarb or equal |
877 |
822 |
$1K |
| S0621 |
Routine ophthalmological exa |
226 |
181 |
$1K |
| V2750 |
Anti-reflective coating |
824 |
781 |
$306.00 |
| V2107 |
Spherocylinder 4.25d/12-2d |
24 |
16 |
$289.00 |
| V2744 |
Tint photochromatic lens/es |
28 |
26 |
$86.00 |
| 92014 |
|
28 |
28 |
$0.00 |