WAL-MART STORES EAST LP
NPI: 1407873623
· NEW CASTLE, PA 16101
· 332B00000X
$254K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
21 |
$400.00 |
| 2020 |
309 |
$12K |
| 2021 |
1,895 |
$77K |
| 2022 |
2,921 |
$130K |
| 2023 |
516 |
$23K |
| 2024 |
223 |
$10K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Eyeglasses delux frames |
3,168 |
2,589 |
$206K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,343 |
1,123 |
$22K |
| V2100 |
Lens spher single plano 4.00 |
692 |
564 |
$11K |
| V2523 |
Cntct lens hydrophil extend |
89 |
62 |
$6K |
| V2750 |
Anti-reflective coating |
412 |
345 |
$5K |
| V2781 |
Progressive lens per lens |
24 |
12 |
$2K |
| V2020 |
Vision svcs frames purchases |
53 |
50 |
$1K |
| V2784 |
Lens polycarb or equal |
89 |
87 |
$971.00 |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
15 |
13 |
$487.50 |