WAL-MART STORES EAST LP
NPI: 1235243205
· LORAIN, OH 44053
· 156FX1800X
$130K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,072 |
$14K |
| 2019 |
1,445 |
$19K |
| 2020 |
684 |
$16K |
| 2021 |
1,106 |
$30K |
| 2022 |
1,493 |
$39K |
| 2023 |
656 |
$9K |
| 2024 |
150 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
3,350 |
3,182 |
$79K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,628 |
1,553 |
$29K |
| V2100 |
Lens spher single plano 4.00 |
495 |
464 |
$8K |
| V2784 |
Lens polycarb or equal |
526 |
501 |
$7K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
79 |
79 |
$2K |
| V2755 |
Uv lens/es |
285 |
283 |
$2K |
| V2750 |
Anti-reflective coating |
166 |
166 |
$2K |
| V2025 |
Eyeglasses delux frames |
77 |
77 |
$159.00 |