WALMART STORES EAST, LP
NPI: 1770667099
· NORWICH, CT 06360
· 156FX1800X
$214K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
3,910 |
$20K |
| 2019 |
3,223 |
$49K |
| 2020 |
1,125 |
$25K |
| 2021 |
2,391 |
$38K |
| 2022 |
2,213 |
$19K |
| 2023 |
3,829 |
$37K |
| 2024 |
2,290 |
$26K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
11,537 |
7,479 |
$129K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
6,238 |
4,070 |
$74K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
449 |
317 |
$6K |
| V2100 |
Lens spher single plano 4.00 |
685 |
527 |
$5K |
| V2107 |
Spherocylinder 4.25d/12-2d |
22 |
18 |
$0.00 |
| V2781 |
Progressive lens per lens |
50 |
37 |
$0.00 |