WAL-MART STORES EAST, LP
NPI: 1972689388
· STRATFORD, CT 06614
· 156FX1800X
$175K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
746 |
$4K |
| 2019 |
1,844 |
$25K |
| 2020 |
875 |
$19K |
| 2021 |
2,252 |
$36K |
| 2022 |
2,134 |
$19K |
| 2023 |
4,006 |
$38K |
| 2024 |
3,037 |
$32K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
8,896 |
5,853 |
$104K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
4,040 |
2,644 |
$48K |
| V2100 |
Lens spher single plano 4.00 |
1,511 |
1,018 |
$16K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
272 |
200 |
$5K |
| S0580 |
Polycarb lens |
13 |
13 |
$383.24 |
| V2784 |
Lens polycarb or equal |
111 |
79 |
$0.00 |
| V2781 |
Progressive lens per lens |
51 |
31 |
$0.00 |