WAL-MART STORES EAST, LP
NPI: 1174615884
· MIDDLETOWN, OH 45044
· 156FX1800X
$379K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,609 |
$30K |
| 2019 |
2,789 |
$49K |
| 2020 |
988 |
$25K |
| 2021 |
2,472 |
$74K |
| 2022 |
3,363 |
$121K |
| 2023 |
2,680 |
$33K |
| 2024 |
2,641 |
$47K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
7,650 |
6,898 |
$200K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
4,701 |
4,179 |
$90K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
976 |
952 |
$34K |
| V2784 |
Lens polycarb or equal |
1,248 |
1,225 |
$27K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
508 |
423 |
$9K |
| V2100 |
Lens spher single plano 4.00 |
420 |
358 |
$7K |
| V2750 |
Anti-reflective coating |
549 |
526 |
$6K |
| V2410 |
Lens variab asphericity sing |
51 |
51 |
$3K |
| V2107 |
Spherocylinder 4.25d/12-2d |
102 |
85 |
$2K |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
12 |
12 |
$822.00 |
| V2755 |
Uv lens/es |
18 |
18 |
$144.00 |
| V2744 |
Tint photochromatic lens/es |
53 |
47 |
$11.40 |
| V2799 |
Misc vision item or service |
254 |
233 |
$10.00 |