WAL-MART STORES EAST, LP
NPI: 1811060429
· FREDERICK, MD 21704
· 156FX1800X
$128K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
1,073 |
$12K |
| 2021 |
1,980 |
$30K |
| 2022 |
1,564 |
$25K |
| 2023 |
1,887 |
$34K |
| 2024 |
1,425 |
$27K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
3,524 |
3,299 |
$92K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,827 |
1,692 |
$21K |
| V2100 |
Lens spher single plano 4.00 |
1,010 |
947 |
$13K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
67 |
67 |
$791.50 |
| V2784 |
Lens polycarb or equal |
526 |
471 |
$621.00 |
| V2750 |
Anti-reflective coating |
975 |
902 |
$136.00 |