WAL-MART STORES EAST, LP
NPI: 1679658546
· MASON, OH 45040
· 156FX1800X
$153K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
958 |
$20K |
| 2019 |
634 |
$10K |
| 2020 |
395 |
$9K |
| 2021 |
557 |
$18K |
| 2022 |
1,974 |
$68K |
| 2023 |
1,465 |
$17K |
| 2024 |
659 |
$11K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
3,448 |
2,924 |
$95K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,054 |
1,679 |
$39K |
| V2100 |
Lens spher single plano 4.00 |
286 |
245 |
$6K |
| V2410 |
Lens variab asphericity sing |
77 |
77 |
$5K |
| V2750 |
Anti-reflective coating |
508 |
448 |
$3K |
| V2784 |
Lens polycarb or equal |
192 |
185 |
$3K |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
31 |
31 |
$2K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
26 |
26 |
$601.60 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
20 |
12 |
$0.00 |