WAL-MART STORES EAST, LP
NPI: 1790867927
· GERMANTOWN, MD 20876
· 156FX1800X
$206K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
906 |
$17K |
| 2021 |
2,166 |
$46K |
| 2022 |
2,113 |
$49K |
| 2023 |
2,565 |
$56K |
| 2024 |
1,613 |
$38K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
3,891 |
3,740 |
$138K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,354 |
2,232 |
$36K |
| V2100 |
Lens spher single plano 4.00 |
690 |
660 |
$12K |
| 92014 |
|
165 |
154 |
$8K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
439 |
421 |
$6K |
| 92004 |
|
82 |
80 |
$4K |
| V2784 |
Lens polycarb or equal |
225 |
218 |
$875.00 |
| V2750 |
Anti-reflective coating |
971 |
931 |
$221.00 |
| 3072F |
|
507 |
482 |
$0.00 |
| V2744 |
Tint photochromatic lens/es |
25 |
25 |
$0.00 |
| V2799 |
Misc vision item or service |
14 |
13 |
$0.00 |