WAL-MART STORES EAST LP
NPI: 1831452614
· KITTANNING, PA 16201
· 156FX1800X
$130K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
221 |
$9K |
| 2021 |
753 |
$32K |
| 2022 |
1,014 |
$46K |
| 2023 |
865 |
$36K |
| 2024 |
154 |
$7K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Eyeglasses delux frames |
1,752 |
1,506 |
$107K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,018 |
887 |
$18K |
| V2100 |
Lens spher single plano 4.00 |
135 |
113 |
$2K |
| V2520 |
Contact lens hydrophilic |
25 |
25 |
$2K |
| V2020 |
Vision svcs frames purchases |
39 |
30 |
$721.68 |
| V2784 |
Lens polycarb or equal |
38 |
37 |
$429.00 |