WAL-MART STORES EAST, LP
NPI: 1477667400
· YOUNGSTOWN, OH 44514
· 156FX1800X
$201K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
296 |
$4K |
| 2019 |
428 |
$6K |
| 2020 |
691 |
$18K |
| 2021 |
1,790 |
$47K |
| 2022 |
2,924 |
$78K |
| 2023 |
2,312 |
$36K |
| 2024 |
808 |
$13K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
4,344 |
3,882 |
$112K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,110 |
1,811 |
$41K |
| V2100 |
Lens spher single plano 4.00 |
1,215 |
1,049 |
$25K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
229 |
228 |
$9K |
| V2784 |
Lens polycarb or equal |
700 |
662 |
$8K |
| V2520 |
Contact lens hydrophilic |
14 |
13 |
$2K |
| V2781 |
Progressive lens per lens |
25 |
25 |
$1K |
| V2200 |
Lens spher bifoc plano 4.00d |
34 |
25 |
$1K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
14 |
12 |
$348.50 |
| V2744 |
Tint photochromatic lens/es |
12 |
12 |
$248.90 |
| V2025 |
Eyeglasses delux frames |
320 |
320 |
$110.00 |
| V2750 |
Anti-reflective coating |
232 |
227 |
$0.00 |