WAL-MART STORES EAST, LP
NPI: 1831296433
· ITHACA, NY 14850
· 156FX1800X
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
27 |
$2K |
| 2023 |
27 |
$3K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
42 |
42 |
$4K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
12 |
12 |
$244.25 |