WAL-MART STORES EAST LP
NPI: 1538586797
· DUBLIN, OH 43016
· 156FX1800X
$155K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
264 |
$4K |
| 2019 |
569 |
$10K |
| 2020 |
924 |
$21K |
| 2021 |
1,280 |
$34K |
| 2022 |
1,876 |
$63K |
| 2023 |
1,299 |
$15K |
| 2024 |
525 |
$8K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
2,990 |
2,581 |
$95K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,915 |
1,609 |
$38K |
| V2784 |
Lens polycarb or equal |
717 |
692 |
$11K |
| V2100 |
Lens spher single plano 4.00 |
428 |
369 |
$9K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
26 |
26 |
$995.00 |
| V2025 |
Eyeglasses delux frames |
87 |
87 |
$870.00 |
| V2107 |
Spherocylinder 4.25d/12-2d |
12 |
12 |
$250.50 |
| V2750 |
Anti-reflective coating |
562 |
522 |
$0.00 |