WAL-MART STORES EAST, LP
NPI: 1386726156
· JOHNSON CITY, TN 37604
· 156FX1800X
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
98 |
$345.95 |
| 2022 |
249 |
$364.15 |
| 2023 |
596 |
$779.65 |
| 2024 |
444 |
$364.05 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
647 |
505 |
$2K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
20 |
17 |
$118.90 |
| V2784 |
Lens polycarb or equal |
207 |
154 |
$93.00 |
| V2781 |
Progressive lens per lens |
78 |
65 |
$0.00 |
| V2744 |
Tint photochromatic lens/es |
53 |
53 |
$0.00 |
| V2702 |
Deluxe lens feature |
13 |
13 |
$0.00 |
| V2750 |
Anti-reflective coating |
369 |
292 |
$0.00 |