WAL-MART STORES EAST, LP
NPI: 1326151168
· NORTH CANTON, OH 44720
· 156FX1800X
$165K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
65 |
$971.00 |
| 2019 |
773 |
$11K |
| 2020 |
830 |
$21K |
| 2021 |
1,227 |
$34K |
| 2022 |
2,119 |
$73K |
| 2023 |
1,145 |
$16K |
| 2024 |
581 |
$10K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
3,626 |
3,297 |
$103K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,340 |
2,085 |
$47K |
| V2100 |
Lens spher single plano 4.00 |
445 |
396 |
$8K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
73 |
71 |
$3K |
| V2784 |
Lens polycarb or equal |
90 |
89 |
$2K |
| V2523 |
Cntct lens hydrophil extend |
12 |
12 |
$1K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
15 |
12 |
$318.25 |
| V2750 |
Anti-reflective coating |
38 |
37 |
$230.00 |
| V2025 |
Eyeglasses delux frames |
101 |
101 |
$130.00 |