WAL-MART STORES EAST, LP
NPI: 1851483002
· BEAVERCREEK, OH 45431
· 156FX1800X
$2.04M
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
24,063 |
$478K |
| 2019 |
33,441 |
$679K |
| 2020 |
21,539 |
$437K |
| 2021 |
17,537 |
$357K |
| 2022 |
1,834 |
$61K |
| 2023 |
1,339 |
$17K |
| 2024 |
665 |
$10K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
54,521 |
54,187 |
$1.10M |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
22,098 |
21,931 |
$532K |
| V2784 |
Lens polycarb or equal |
18,505 |
18,419 |
$240K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
2,354 |
2,349 |
$111K |
| V2100 |
Lens spher single plano 4.00 |
2,079 |
2,005 |
$43K |
| V2781 |
Progressive lens per lens |
192 |
192 |
$6K |
| V2523 |
Cntct lens hydrophil extend |
39 |
39 |
$5K |
| V2107 |
Spherocylinder 4.25d/12-2d |
12 |
12 |
$246.50 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
12 |
12 |
$207.50 |
| V2750 |
Anti-reflective coating |
593 |
578 |
$0.00 |
| 92015 |
|
13 |
13 |
$0.00 |