WAL-MART STORES EAST, LP
NPI: 1932202975
· SPRINGFIELD, OH 45503
· 156FX1800X
$199K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,446 |
$25K |
| 2019 |
1,377 |
$23K |
| 2020 |
1,324 |
$29K |
| 2021 |
1,578 |
$40K |
| 2022 |
1,774 |
$59K |
| 2023 |
1,405 |
$15K |
| 2024 |
527 |
$8K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
4,394 |
4,117 |
$105K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,493 |
2,333 |
$44K |
| V2784 |
Lens polycarb or equal |
1,133 |
1,118 |
$20K |
| V2100 |
Lens spher single plano 4.00 |
727 |
670 |
$13K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
348 |
347 |
$12K |
| V2750 |
Anti-reflective coating |
244 |
239 |
$3K |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
17 |
17 |
$1K |
| V2410 |
Lens variab asphericity sing |
14 |
14 |
$896.00 |
| V2025 |
Eyeglasses delux frames |
30 |
30 |
$280.00 |
| V2107 |
Spherocylinder 4.25d/12-2d |
12 |
12 |
$174.80 |
| V2755 |
Uv lens/es |
19 |
19 |
$152.00 |