WAL-MART STORES EAST, LP
NPI: 1609971415
· GALLIPOLIS, OH 45631
· 156FX1800X
$229K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,276 |
$22K |
| 2019 |
1,140 |
$19K |
| 2020 |
1,351 |
$34K |
| 2021 |
1,806 |
$51K |
| 2022 |
2,318 |
$83K |
| 2023 |
83 |
$72.50 |
| 2024 |
1,221 |
$20K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
4,539 |
4,431 |
$133K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,410 |
2,345 |
$47K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
658 |
657 |
$22K |
| V2100 |
Lens spher single plano 4.00 |
792 |
773 |
$16K |
| V2784 |
Lens polycarb or equal |
679 |
677 |
$9K |
| V2200 |
Lens spher bifoc plano 4.00d |
42 |
42 |
$2K |
| V2750 |
Anti-reflective coating |
45 |
45 |
$920.00 |
| V2025 |
Eyeglasses delux frames |
30 |
30 |
$89.00 |