WAL-MART STORES EAST, LP
NPI: 1154402964
· BLUE SPRINGS, MO 64014
· 156FX1800X
$129K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,046 |
$14K |
| 2019 |
889 |
$12K |
| 2020 |
410 |
$5K |
| 2021 |
989 |
$7K |
| 2022 |
1,362 |
$25K |
| 2023 |
1,491 |
$55K |
| 2024 |
887 |
$11K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
3,036 |
3,035 |
$64K |
| 92002 |
|
397 |
397 |
$22K |
| V2100 |
Lens spher single plano 4.00 |
1,446 |
1,441 |
$14K |
| 92012 |
|
257 |
257 |
$14K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,393 |
1,393 |
$11K |
| 92004 |
|
21 |
21 |
$2K |
| 92014 |
|
22 |
22 |
$1K |
| 92015 |
|
94 |
94 |
$497.93 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
40 |
40 |
$290.00 |
| V2025 |
Eyeglasses delux frames |
368 |
368 |
$0.00 |