WAL-MART STORES EAST, LP
NPI: 1316028491
· SALEM, MO 65560
· 156FX1800X
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
250 |
$4K |
| 2019 |
413 |
$7K |
| 2020 |
156 |
$3K |
| 2021 |
13 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
521 |
512 |
$9K |
| V2100 |
Lens spher single plano 4.00 |
162 |
157 |
$2K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
95 |
89 |
$1K |
| V2781 |
Progressive lens per lens |
27 |
27 |
$827.50 |
| 92004 |
|
14 |
14 |
$718.90 |
| V2025 |
Eyeglasses delux frames |
13 |
13 |
$0.00 |