WAL-MART STORES EAST, LP
NPI: 1316028798
· JACKSBORO, TN 37757
· 156FX1800X
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
373 |
$3K |
| 2019 |
840 |
$5K |
| 2020 |
581 |
$3K |
| 2021 |
867 |
$3K |
| 2022 |
1,197 |
$3K |
| 2023 |
935 |
$3K |
| 2024 |
49 |
$315.40 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
2,138 |
1,959 |
$13K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
373 |
352 |
$5K |
| V2784 |
Lens polycarb or equal |
686 |
621 |
$706.00 |
| V2750 |
Anti-reflective coating |
749 |
706 |
$675.00 |
| V2744 |
Tint photochromatic lens/es |
502 |
477 |
$164.95 |
| V2781 |
Progressive lens per lens |
334 |
310 |
$72.50 |
| V2025 |
Eyeglasses delux frames |
12 |
12 |
$0.00 |
| V2702 |
Deluxe lens feature |
48 |
44 |
$0.00 |