WAL-MART STORES EAST, LP
NPI: 1568546190
· UNIONTOWN, PA 15401
· 332H00000X
$162K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
243 |
$7K |
| 2021 |
2,108 |
$50K |
| 2022 |
1,241 |
$30K |
| 2023 |
649 |
$18K |
| 2024 |
1,577 |
$57K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,668 |
1,406 |
$56K |
| V2020 |
Vision svcs frames purchases |
2,785 |
2,354 |
$46K |
| V2025 |
Eyeglasses delux frames |
530 |
529 |
$31K |
| V2100 |
Lens spher single plano 4.00 |
520 |
445 |
$18K |
| V2520 |
Contact lens hydrophilic |
57 |
57 |
$4K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
76 |
76 |
$2K |
| V2107 |
Spherocylinder 4.25d/12-2d |
40 |
39 |
$2K |
| V2115 |
Lens lenticular bifocal |
14 |
13 |
$1K |
| V2750 |
Anti-reflective coating |
87 |
84 |
$1K |
| V2784 |
Lens polycarb or equal |
41 |
41 |
$480.00 |