WAL-MART STORES EAST, LP
NPI: 1073695623
· GROTON, CT 06340
· 156FX1800X
$186K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,643 |
$15K |
| 2019 |
2,256 |
$35K |
| 2020 |
1,816 |
$31K |
| 2021 |
3,469 |
$39K |
| 2022 |
1,401 |
$13K |
| 2023 |
2,914 |
$31K |
| 2024 |
2,028 |
$23K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
10,109 |
6,218 |
$111K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
5,340 |
3,359 |
$63K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
547 |
269 |
$9K |
| V2100 |
Lens spher single plano 4.00 |
440 |
276 |
$3K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
54 |
26 |
$317.50 |
| V2750 |
Anti-reflective coating |
37 |
24 |
$0.00 |