WAL-MART STORES EAST, LP
NPI: 1730260191
· MANASSAS, VA 20109
· 332H00000X
$115K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,600 |
$78K |
| 2019 |
848 |
$36K |
| 2023 |
55 |
$718.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Lens spher single plano 4.00 |
856 |
853 |
$77K |
| V2020 |
Vision svcs frames purchases |
995 |
989 |
$25K |
| V2750 |
Anti-reflective coating |
596 |
596 |
$11K |
| V2744 |
Tint photochromatic lens/es |
40 |
40 |
$1K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
16 |
16 |
$333.50 |