WAL-MART STORES EAST LP
NPI: 1295752350
· INDIANA, PA 15701
· 332B00000X
$343K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
13 |
$260.00 |
| 2020 |
450 |
$15K |
| 2021 |
2,177 |
$77K |
| 2022 |
3,522 |
$117K |
| 2023 |
2,449 |
$93K |
| 2024 |
1,204 |
$41K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Eyeglasses delux frames |
3,875 |
3,407 |
$220K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,310 |
2,004 |
$37K |
| V2781 |
Progressive lens per lens |
240 |
194 |
$21K |
| V2750 |
Anti-reflective coating |
1,136 |
946 |
$15K |
| V2520 |
Contact lens hydrophilic |
220 |
204 |
$14K |
| V2784 |
Lens polycarb or equal |
874 |
723 |
$10K |
| V2100 |
Lens spher single plano 4.00 |
688 |
610 |
$9K |
| V2521 |
Cntct lens hydrophilic toric |
102 |
91 |
$6K |
| V2744 |
Tint photochromatic lens/es |
92 |
78 |
$5K |
| V2020 |
Vision svcs frames purchases |
209 |
145 |
$4K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
45 |
44 |
$656.00 |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
24 |
12 |
$0.00 |