WAL-MART STORES EAST, LP
NPI: 1750462768
· APPLETON, WI 54913
· 156FX1800X
$359K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
3,010 |
$74K |
| 2019 |
2,169 |
$50K |
| 2020 |
1,777 |
$42K |
| 2021 |
1,767 |
$44K |
| 2022 |
2,292 |
$53K |
| 2023 |
2,932 |
$67K |
| 2024 |
1,302 |
$29K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
5,538 |
5,112 |
$244K |
| 92015 |
|
5,579 |
5,155 |
$44K |
| V2020 |
Vision svcs frames purchases |
2,241 |
2,024 |
$33K |
| V2100 |
Lens spher single plano 4.00 |
876 |
761 |
$23K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
724 |
640 |
$15K |
| V2784 |
Lens polycarb or equal |
70 |
69 |
$140.50 |
| V2025 |
Eyeglasses delux frames |
67 |
61 |
$0.00 |
| V2750 |
Anti-reflective coating |
154 |
152 |
$0.00 |