WAL-MART STORES EAST, LP
NPI: 1427147487
· NEWINGTON, CT 06111
· 156FX1800X
$161K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
3,592 |
$20K |
| 2019 |
2,929 |
$44K |
| 2020 |
1,681 |
$28K |
| 2021 |
2,097 |
$24K |
| 2022 |
929 |
$7K |
| 2023 |
1,474 |
$13K |
| 2024 |
2,364 |
$26K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
8,994 |
5,417 |
$95K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
4,726 |
2,854 |
$51K |
| V2100 |
Lens spher single plano 4.00 |
829 |
515 |
$10K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
185 |
116 |
$4K |
| S0580 |
Polycarb lens |
37 |
26 |
$678.04 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
24 |
12 |
$246.50 |
| V2781 |
Progressive lens per lens |
77 |
51 |
$0.00 |
| V2750 |
Anti-reflective coating |
194 |
149 |
$0.00 |