WAL-MART STORES EAST, LP
NPI: 1245312396
· LANCASTER, PA 17602
· 156FX1800X
$577K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
1,222 |
$36K |
| 2021 |
4,589 |
$138K |
| 2022 |
5,856 |
$179K |
| 2023 |
4,081 |
$124K |
| 2024 |
2,754 |
$99K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
5,514 |
4,715 |
$124K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
3,862 |
2,119 |
$120K |
| 92004 |
|
2,324 |
2,257 |
$95K |
| 92014 |
|
1,922 |
1,888 |
$78K |
| V2100 |
Lens spher single plano 4.00 |
1,615 |
1,025 |
$56K |
| V2200 |
Lens spher bifoc plano 4.00d |
808 |
481 |
$34K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
469 |
310 |
$21K |
| 92012 |
|
306 |
306 |
$12K |
| V2115 |
Lens lenticular bifocal |
110 |
96 |
$10K |
| 92002 |
|
197 |
196 |
$8K |
| V2781 |
Progressive lens per lens |
567 |
305 |
$8K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
182 |
125 |
$6K |
| V2025 |
Eyeglasses delux frames |
83 |
83 |
$4K |
| V2107 |
Spherocylinder 4.25d/12-2d |
63 |
39 |
$2K |
| V2744 |
Tint photochromatic lens/es |
356 |
202 |
$375.00 |
| V2750 |
Anti-reflective coating |
96 |
64 |
$303.00 |
| V2784 |
Lens polycarb or equal |
28 |
13 |
$0.00 |