WAL-MART STORES EAST LP
NPI: 1235520370
· NEW BERLIN, WI 53151
· 156FX1800X
$111K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
84 |
$1K |
| 2019 |
154 |
$3K |
| 2020 |
114 |
$2K |
| 2021 |
919 |
$20K |
| 2022 |
1,293 |
$32K |
| 2023 |
1,601 |
$35K |
| 2024 |
849 |
$18K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
2,720 |
2,565 |
$45K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
908 |
865 |
$23K |
| V2781 |
Progressive lens per lens |
234 |
208 |
$22K |
| V2100 |
Lens spher single plano 4.00 |
727 |
663 |
$20K |
| V2784 |
Lens polycarb or equal |
173 |
153 |
$818.50 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
13 |
13 |
$268.75 |
| V2750 |
Anti-reflective coating |
239 |
221 |
$0.00 |