WAL-MART STORES EAST, LP
NPI: 1134202872
· CANTON, OH 44708
· 156FX1800X
$148K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
292 |
$4K |
| 2019 |
306 |
$4K |
| 2020 |
566 |
$12K |
| 2021 |
1,168 |
$29K |
| 2022 |
2,035 |
$63K |
| 2023 |
1,553 |
$22K |
| 2024 |
808 |
$13K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
3,854 |
3,492 |
$89K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,994 |
1,777 |
$38K |
| V2100 |
Lens spher single plano 4.00 |
539 |
481 |
$10K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
245 |
236 |
$10K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
22 |
15 |
$429.50 |
| V2750 |
Anti-reflective coating |
12 |
12 |
$230.00 |
| V2025 |
Eyeglasses delux frames |
62 |
62 |
$0.00 |