WAL-MART STORES EAST, LP
NPI: 1871674317
· ABERDEEN, MD 21001
· 156FX1800X
$316K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
2,342 |
$22K |
| 2021 |
4,262 |
$54K |
| 2022 |
4,901 |
$75K |
| 2023 |
5,207 |
$86K |
| 2024 |
4,389 |
$79K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
8,176 |
7,766 |
$192K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
4,747 |
4,449 |
$53K |
| V2100 |
Lens spher single plano 4.00 |
2,008 |
1,882 |
$30K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
639 |
607 |
$15K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
763 |
712 |
$7K |
| V2784 |
Lens polycarb or equal |
1,628 |
1,525 |
$6K |
| V2750 |
Anti-reflective coating |
2,434 |
2,304 |
$5K |
| V2781 |
Progressive lens per lens |
131 |
120 |
$4K |
| V2025 |
Eyeglasses delux frames |
53 |
51 |
$1K |
| V2744 |
Tint photochromatic lens/es |
300 |
287 |
$1K |
| V2107 |
Spherocylinder 4.25d/12-2d |
94 |
91 |
$1K |
| V2799 |
Misc vision item or service |
128 |
116 |
$0.00 |