WAL-MART STORES EAST, LP
NPI: 1588675292
· SANDUSKY, OH 44870
· 156FX1800X
$104K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
725 |
$13K |
| 2019 |
536 |
$9K |
| 2020 |
486 |
$10K |
| 2021 |
1,056 |
$24K |
| 2022 |
1,323 |
$31K |
| 2023 |
1,138 |
$16K |
| 2024 |
30 |
$377.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
2,505 |
2,357 |
$50K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,308 |
1,217 |
$28K |
| V2784 |
Lens polycarb or equal |
949 |
927 |
$17K |
| V2100 |
Lens spher single plano 4.00 |
372 |
326 |
$8K |
| V2107 |
Spherocylinder 4.25d/12-2d |
13 |
13 |
$271.00 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
13 |
13 |
$252.00 |
| V2025 |
Eyeglasses delux frames |
43 |
43 |
$100.00 |
| V2750 |
Anti-reflective coating |
91 |
90 |
$0.00 |