WAL-MART STORES LOUISIANA, LLC
NPI: 1568545036
· RUSTON, LA 71270
· 156FX1800X
$101K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
160 |
$2K |
| 2020 |
326 |
$5K |
| 2021 |
856 |
$14K |
| 2022 |
1,294 |
$26K |
| 2023 |
1,489 |
$27K |
| 2024 |
1,452 |
$28K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
3,263 |
2,671 |
$63K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,423 |
1,142 |
$22K |
| V2100 |
Lens spher single plano 4.00 |
792 |
668 |
$14K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
30 |
26 |
$943.50 |
| V2784 |
Lens polycarb or equal |
69 |
63 |
$430.78 |