Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Pennsylvania for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Pennsylvania only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Pennsylvania (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Wal-mart Stores, Inc. (NPI 1225286511)

Field	Value
Entity Type	Organization
Organization	Wal-mart Stores, Inc.
Address	275 N. Gulph Rd
City	King Of Prussia
State	PA
ZIP	19406
Taxonomy	Optician
NPI Enumerated	August 29, 2008

Payer Source	Total Paid
Medicaid	$5.7M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

30 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
V2025	Deluxe frame	47,600	$60	$2.9M
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	29,990	$20	$509.8K
V2781	Progressive lens, per lens	5,070	$80	$416K
V2520	Contact lens, hydrophilic, spherical, per lens	4,170	$60	$266.6K
V2744	Tint, photochromatic, per lens	4,140	$60	$227.6K
V2020	Frames, purchases	7,900	$30	$197.4K
V2521	Contact lens, hydrophilic, toric, or prism ballast, per lens	3,080	$60	$197.2K
V2523	Contact lens, hydrophilic, extended wear, per lens	2,610	$60	$164.2K
V2203	Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	4,650	$40	$162.8K
S0620	Routine ophthalmological examination including refraction; new patient	3,030	$50	$136.1K

Showing 1–10 of 30

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.

Claims Volume vs. Pennsylvania Distribution

Wal-mart Stores, Inc. — 16 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	43	620	350	$30	$64.6K
V2783	Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens	4	20	350	$40	$50.2K
V2025	Deluxe frame	1	150	140	$50	$47.1K
V2020	Frames, purchases	39	1,020	400	$30	$45.5K
V2101	Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens	8	10	290	$20	$41.2K
V2784	Lens, polycarbonate or equal, any index, per lens	38	520	400	$10	$28.1K
V2521	Contact lens, hydrophilic, toric, or prism ballast, per lens	1	10	30	$60	$27.7K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	1	400	250	$20	$24.5K
V2523	Contact lens, hydrophilic, extended wear, per lens	1	10	60	$60	$19.4K
V2781	Progressive lens, per lens	2	60	70	$40	$15.6K

Showing 1–10 of 30

Related Providers

Other providers that share a Tax Identification Number (TIN) with Wal-mart Stores, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
John Passarelli	NY	Ophthalmology Physician	$360K	$38.4K
Wal-mart Stores East LP	WI	Community/Retail Pharmacy	$227.1K	$6.6K
Wal-mart Stores East , LP	WI	Community/Retail Pharmacy	$218.1K	$3.5K
Wal-mart Stores East LP	NC	Community/Retail Pharmacy	$212.9K	$1.6K
Wal-mart Stores East, LP	WI	Community/Retail Pharmacy	$169.3K	$570
Wal-mart Stores East LP	MA	Community/Retail Pharmacy	$168.6K	$0
Jesse Blattstein	NY	Occupational Vision Optometrist	$168.5K	$0
Wal-mart Stores East LP	SC	Community/Retail Pharmacy	$167.8K	$0
Wal-mart Stores East, LP	GA	Eyewear Supplier	$0	$165.6K
Wal-mart Stores East LP	WI	Community/Retail Pharmacy	$160.3K	$2K

Nearby Providers

Other providers in the same ZIP code as Wal-mart Stores, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Promptcare Companies, Inc.	PA	Oxygen Equipment & Supplies (DME)	$0	$78.5M
Behavior Interventions, Inc	PA	Behavior Analyst	$0	$73.7M
Children's Hospital Of Philadelphia	PA	Durable Medical Equipment & Medical Supplies	$0	$27.6M
Cnnh Therapy LLC	PA	Behavior Analyst	$0	$26.2M
Children's Hospital Of Philadelphia	PA	Home Infusion Agency	$0	$23.1M
Helping Hands Family Pennsylvania LLC	PA	Community/Behavioral Health Agency	$0	$15.8M
Trustees Of The University Of Pennsylvania	PA	Home Infusion Agency	$159.1K	$7.2M
Ambulnz PA, LLC	PA	Ambulance	$3.3M	$3.8M
Quality Life Healthcare LLC	PA	Nursing Care Agency	$0	$6.3M
Main Line Spine Surgery Center, LLC	PA	Ambulatory Surgical Clinic/Center	$3.8M	$0

Wal-mart Stores, Inc. — Billing Profile & Reimbursement Data

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Wal-mart Stores, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References