WAL-MART STORES EAST, LP
NPI: 1134202690
· TARENTUM, PA 15084
· 156FX1800X
$284K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
519 |
$11K |
| 2021 |
2,696 |
$72K |
| 2022 |
2,251 |
$92K |
| 2023 |
1,644 |
$61K |
| 2024 |
1,341 |
$48K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Eyeglasses delux frames |
2,160 |
1,834 |
$141K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,247 |
1,987 |
$63K |
| V2020 |
Vision svcs frames purchases |
2,093 |
1,864 |
$34K |
| V2100 |
Lens spher single plano 4.00 |
565 |
499 |
$19K |
| V2750 |
Anti-reflective coating |
1,011 |
906 |
$9K |
| V2523 |
Cntct lens hydrophil extend |
122 |
95 |
$9K |
| V2781 |
Progressive lens per lens |
30 |
27 |
$2K |
| V2520 |
Contact lens hydrophilic |
21 |
21 |
$2K |
| V2784 |
Lens polycarb or equal |
137 |
116 |
$1K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
27 |
24 |
$1K |
| V2521 |
Cntct lens hydrophilic toric |
13 |
12 |
$920.00 |
| V2107 |
Spherocylinder 4.25d/12-2d |
13 |
12 |
$336.26 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
12 |
12 |
$180.00 |