WAL-MART STORES EAST, LP
NPI: 1417060252
· ASHTABULA, OH 44004
· 156FX1800X
$162K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,308 |
$21K |
| 2019 |
1,211 |
$21K |
| 2020 |
860 |
$20K |
| 2021 |
1,296 |
$32K |
| 2022 |
2,101 |
$53K |
| 2023 |
953 |
$13K |
| 2024 |
192 |
$3K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
3,451 |
3,374 |
$84K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,841 |
1,795 |
$36K |
| V2784 |
Lens polycarb or equal |
1,175 |
1,162 |
$19K |
| V2100 |
Lens spher single plano 4.00 |
503 |
479 |
$11K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
164 |
164 |
$6K |
| V2750 |
Anti-reflective coating |
531 |
522 |
$3K |
| V2200 |
Lens spher bifoc plano 4.00d |
27 |
27 |
$1K |
| V2025 |
Eyeglasses delux frames |
192 |
192 |
$1K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
12 |
12 |
$212.50 |
| V2744 |
Tint photochromatic lens/es |
25 |
25 |
$172.90 |