WAL-MART STORES EAST, LP
NPI: 1730260258
· WASHINGTON, PA 15301
· 156FX1800X
$364K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
606 |
$17K |
| 2021 |
3,143 |
$106K |
| 2022 |
2,468 |
$87K |
| 2023 |
2,357 |
$84K |
| 2024 |
1,918 |
$71K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Eyeglasses delux frames |
3,351 |
2,994 |
$201K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,747 |
2,410 |
$64K |
| V2020 |
Vision svcs frames purchases |
1,897 |
1,639 |
$32K |
| V2100 |
Lens spher single plano 4.00 |
694 |
599 |
$17K |
| 92002 |
|
419 |
410 |
$17K |
| V2523 |
Cntct lens hydrophil extend |
106 |
99 |
$7K |
| V2750 |
Anti-reflective coating |
609 |
550 |
$6K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
107 |
95 |
$5K |
| V2520 |
Contact lens hydrophilic |
55 |
42 |
$4K |
| V2784 |
Lens polycarb or equal |
308 |
286 |
$3K |
| V2781 |
Progressive lens per lens |
37 |
34 |
$3K |
| V2744 |
Tint photochromatic lens/es |
37 |
27 |
$2K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
66 |
55 |
$2K |
| V2115 |
Lens lenticular bifocal |
14 |
14 |
$834.40 |
| V2107 |
Spherocylinder 4.25d/12-2d |
12 |
12 |
$248.38 |
| V2755 |
Uv lens/es |
33 |
33 |
$222.00 |