WAL-MART STORES EAST, LP
NPI: 1427130673
· SPARTA, TN 38583
· 156FX1800X
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
235 |
$3K |
| 2019 |
367 |
$5K |
| 2020 |
170 |
$2K |
| 2021 |
280 |
$2K |
| 2022 |
384 |
$2K |
| 2023 |
597 |
$3K |
| 2024 |
180 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
1,524 |
1,357 |
$13K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
256 |
244 |
$5K |
| V2100 |
Lens spher single plano 4.00 |
24 |
24 |
$456.70 |
| V2784 |
Lens polycarb or equal |
182 |
138 |
$385.00 |
| V2781 |
Progressive lens per lens |
40 |
30 |
$29.00 |
| V2702 |
Deluxe lens feature |
16 |
15 |
$0.00 |
| V2744 |
Tint photochromatic lens/es |
59 |
55 |
$0.00 |
| V2750 |
Anti-reflective coating |
112 |
106 |
$0.00 |