WAL-MART STORES EAST, LP
NPI: 1982777595
· NEW CASTLE, PA 16101
· 156FX1800X
$109K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
321 |
$11K |
| 2021 |
1,900 |
$53K |
| 2022 |
1,172 |
$34K |
| 2023 |
132 |
$3K |
| 2024 |
156 |
$8K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Lens spher single plano 4.00 |
709 |
619 |
$39K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
652 |
557 |
$34K |
| V2020 |
Vision svcs frames purchases |
1,881 |
1,628 |
$28K |
| V2025 |
Eyeglasses delux frames |
108 |
108 |
$6K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
23 |
12 |
$1K |
| V2599 |
Contact lens/es other type |
13 |
13 |
$1K |
| V2750 |
Anti-reflective coating |
295 |
246 |
$0.00 |