WAL-MART STORES EAST, LP
NPI: 1992818744
· HAMILTON, OH 45013
· 156FX1800X
$394K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,371 |
$21K |
| 2019 |
1,365 |
$22K |
| 2020 |
1,905 |
$48K |
| 2021 |
3,243 |
$85K |
| 2022 |
4,827 |
$156K |
| 2023 |
3,063 |
$41K |
| 2024 |
1,271 |
$22K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
7,993 |
7,090 |
$224K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
4,608 |
4,025 |
$87K |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
936 |
921 |
$35K |
| V2100 |
Lens spher single plano 4.00 |
1,207 |
1,045 |
$22K |
| V2784 |
Lens polycarb or equal |
530 |
510 |
$7K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
434 |
346 |
$7K |
| V2521 |
Cntct lens hydrophilic toric |
49 |
49 |
$5K |
| V2107 |
Spherocylinder 4.25d/12-2d |
192 |
167 |
$4K |
| V2750 |
Anti-reflective coating |
906 |
876 |
$2K |
| V2520 |
Contact lens hydrophilic |
12 |
12 |
$1K |
| V2200 |
Lens spher bifoc plano 4.00d |
12 |
12 |
$530.00 |
| V2744 |
Tint photochromatic lens/es |
153 |
148 |
$172.90 |
| V2025 |
Eyeglasses delux frames |
13 |
13 |
$120.00 |