WAL-MART STORES EAST, L.P.
NPI: 1720119233
· MILFORD, OH 45150
· 156FX1800X
$169K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,206 |
$20K |
| 2019 |
1,404 |
$23K |
| 2020 |
722 |
$18K |
| 2021 |
1,173 |
$32K |
| 2022 |
1,740 |
$57K |
| 2023 |
1,237 |
$15K |
| 2024 |
351 |
$5K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
3,810 |
3,452 |
$97K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,448 |
2,195 |
$47K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
269 |
266 |
$9K |
| V2784 |
Lens polycarb or equal |
504 |
499 |
$7K |
| V2100 |
Lens spher single plano 4.00 |
269 |
239 |
$5K |
| V2750 |
Anti-reflective coating |
346 |
336 |
$3K |
| V2025 |
Eyeglasses delux frames |
143 |
143 |
$1K |
| V2107 |
Spherocylinder 4.25d/12-2d |
19 |
12 |
$378.00 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
12 |
12 |
$223.00 |
| V2744 |
Tint photochromatic lens/es |
13 |
13 |
$0.00 |