WAL-MART STORES EAST, LP
NPI: 1720169865
· KENNETT, MO 63857
· 156FX1800X
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
13 |
$230.50 |
| 2019 |
148 |
$2K |
| 2020 |
26 |
$269.60 |
| 2021 |
221 |
$7K |
| 2022 |
694 |
$21K |
| 2023 |
747 |
$23K |
| 2024 |
268 |
$2K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
1,002 |
1,001 |
$23K |
| 92004 |
|
254 |
254 |
$15K |
| V2100 |
Lens spher single plano 4.00 |
554 |
553 |
$5K |
| 92002 |
|
84 |
84 |
$5K |
| 92014 |
|
78 |
78 |
$5K |
| 92012 |
|
46 |
46 |
$3K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
87 |
87 |
$1K |
| V2781 |
Progressive lens per lens |
12 |
12 |
$58.00 |