WAL-MART STORES EAST, LP
NPI: 1760563324
· SAINT JOSEPH, MO 64503
· 156FX1800X
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
682 |
$25K |
| 2024 |
533 |
$5K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
201 |
201 |
$11K |
| V2020 |
Vision svcs frames purchases |
567 |
567 |
$9K |
| 92002 |
|
105 |
105 |
$6K |
| V2100 |
Lens spher single plano 4.00 |
264 |
263 |
$3K |
| 92014 |
|
13 |
13 |
$784.88 |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
65 |
65 |
$750.00 |