WAL-MART STORES EAST, LP
NPI: 1952485047
· MT PLEASANT, PA 15666
· 156FX1800X
$328K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
452 |
$16K |
| 2021 |
2,394 |
$83K |
| 2022 |
2,594 |
$101K |
| 2023 |
1,980 |
$75K |
| 2024 |
1,351 |
$53K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Eyeglasses delux frames |
3,397 |
2,995 |
$209K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,277 |
1,989 |
$48K |
| V2100 |
Lens spher single plano 4.00 |
983 |
861 |
$23K |
| V2020 |
Vision svcs frames purchases |
1,331 |
1,093 |
$22K |
| V2520 |
Contact lens hydrophilic |
214 |
179 |
$14K |
| V2750 |
Anti-reflective coating |
288 |
245 |
$3K |
| V2744 |
Tint photochromatic lens/es |
47 |
45 |
$2K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
115 |
109 |
$2K |
| V2781 |
Progressive lens per lens |
28 |
24 |
$2K |
| V2521 |
Cntct lens hydrophilic toric |
25 |
24 |
$2K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
37 |
26 |
$1K |
| V2107 |
Spherocylinder 4.25d/12-2d |
12 |
12 |
$228.19 |
| V2784 |
Lens polycarb or equal |
17 |
16 |
$168.00 |