WAL-MART STORES EAST, LP
NPI: 1699881086
· MOUNT VERNON, OH 43050
· 156FX1800X
$183K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,241 |
$20K |
| 2019 |
953 |
$16K |
| 2020 |
1,211 |
$27K |
| 2021 |
1,865 |
$42K |
| 2022 |
2,066 |
$57K |
| 2023 |
1,358 |
$17K |
| 2024 |
304 |
$5K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
3,848 |
3,782 |
$89K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,155 |
2,132 |
$46K |
| V2100 |
Lens spher single plano 4.00 |
1,056 |
1,045 |
$22K |
| V2784 |
Lens polycarb or equal |
1,027 |
1,016 |
$12K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
215 |
215 |
$9K |
| V2025 |
Eyeglasses delux frames |
455 |
455 |
$5K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
12 |
12 |
$246.50 |
| V2744 |
Tint photochromatic lens/es |
12 |
12 |
$96.90 |
| V2750 |
Anti-reflective coating |
218 |
218 |
$80.00 |