WAL-MART STORES EAST, LP
NPI: 1184703134
· GULFPORT, MS 39503
· 156FX1800X
$117K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
230 |
$5K |
| 2020 |
530 |
$12K |
| 2021 |
935 |
$24K |
| 2022 |
1,608 |
$31K |
| 2023 |
1,300 |
$25K |
| 2024 |
1,139 |
$20K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
3,170 |
2,912 |
$64K |
| V2100 |
Lens spher single plano 4.00 |
1,139 |
1,070 |
$27K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,366 |
1,236 |
$26K |
| V2750 |
Anti-reflective coating |
50 |
50 |
$428.40 |
| V2107 |
Spherocylinder 4.25d/12-2d |
17 |
12 |
$220.00 |