WAL-MART STORES EAST, LP
NPI: 1063593051
· MEXICO, MO 65265
· 156FX1800X
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
133 |
$2K |
| 2019 |
95 |
$1K |
| 2022 |
273 |
$4K |
| 2023 |
14 |
$546.07 |
| 2024 |
75 |
$460.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
366 |
366 |
$7K |
| V2100 |
Lens spher single plano 4.00 |
175 |
175 |
$1K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
24 |
24 |
$188.50 |
| V2781 |
Progressive lens per lens |
13 |
13 |
$87.00 |
| 92002 |
|
12 |
12 |
$50.00 |