WAL-MART STORES EAST, LP
NPI: 1497836415
· NEW HAVEN, CT 06513
· 156FX1800X
$408K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
9,365 |
$32K |
| 2019 |
6,179 |
$75K |
| 2020 |
2,870 |
$60K |
| 2021 |
3,997 |
$70K |
| 2022 |
3,497 |
$15K |
| 2023 |
8,256 |
$79K |
| 2024 |
6,953 |
$77K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
22,686 |
13,718 |
$216K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
13,873 |
8,432 |
$140K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
1,157 |
854 |
$24K |
| V2100 |
Lens spher single plano 4.00 |
2,165 |
1,398 |
$18K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
849 |
526 |
$8K |
| V2107 |
Spherocylinder 4.25d/12-2d |
255 |
193 |
$3K |
| V2799 |
Misc vision item or service |
14 |
13 |
$0.00 |
| V2781 |
Progressive lens per lens |
51 |
38 |
$0.00 |
| V2750 |
Anti-reflective coating |
67 |
54 |
$0.00 |