WAL-MART STORES EAST, LP
NPI: 1487735577
· DEXTER, MO 63841
· 156FX1800X
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
97 |
$2K |
| 2023 |
119 |
$5K |
| 2024 |
112 |
$823.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92002 |
|
63 |
63 |
$4K |
| V2020 |
Vision svcs frames purchases |
212 |
212 |
$3K |
| 92004 |
|
12 |
12 |
$602.52 |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
41 |
41 |
$435.00 |