WAL-MART STORES EAST, LP
NPI: 1477564623
· WOOSTER, OH 44691
· 156FX1800X
$278K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
273 |
$4K |
| 2019 |
1,137 |
$17K |
| 2020 |
1,380 |
$31K |
| 2021 |
2,194 |
$56K |
| 2022 |
3,052 |
$102K |
| 2023 |
2,782 |
$48K |
| 2024 |
1,161 |
$21K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
5,719 |
5,224 |
$150K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
3,277 |
2,950 |
$63K |
| V2100 |
Lens spher single plano 4.00 |
1,242 |
1,110 |
$23K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
526 |
510 |
$20K |
| V2521 |
Cntct lens hydrophilic toric |
98 |
93 |
$9K |
| V2784 |
Lens polycarb or equal |
420 |
410 |
$5K |
| V2520 |
Contact lens hydrophilic |
40 |
40 |
$3K |
| V2523 |
Cntct lens hydrophil extend |
25 |
25 |
$2K |
| V2750 |
Anti-reflective coating |
384 |
376 |
$590.00 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
27 |
27 |
$476.00 |
| V2107 |
Spherocylinder 4.25d/12-2d |
24 |
24 |
$378.70 |
| V2025 |
Eyeglasses delux frames |
184 |
184 |
$297.00 |
| V2744 |
Tint photochromatic lens/es |
13 |
13 |
$32.30 |