WAL-MART STORES EAST, LP
NPI: 1790796829
· MARYSVILLE, OH 43040
· 156FX1800X
$115K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
431 |
$7K |
| 2019 |
405 |
$7K |
| 2020 |
240 |
$5K |
| 2021 |
747 |
$25K |
| 2022 |
1,315 |
$55K |
| 2023 |
78 |
$38.50 |
| 2024 |
860 |
$14K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
2,020 |
1,735 |
$77K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,350 |
1,143 |
$28K |
| V2784 |
Lens polycarb or equal |
407 |
403 |
$6K |
| V2100 |
Lens spher single plano 4.00 |
174 |
138 |
$4K |
| V2750 |
Anti-reflective coating |
112 |
95 |
$270.00 |
| V2025 |
Eyeglasses delux frames |
13 |
13 |
$130.00 |