WAL-MART STORES EAST, LP
NPI: 1922198126
· JEFFERSON CITY, TN 37760
· 156FX1800X
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
568 |
$5K |
| 2019 |
933 |
$6K |
| 2020 |
412 |
$2K |
| 2021 |
760 |
$4K |
| 2022 |
1,309 |
$5K |
| 2023 |
1,290 |
$6K |
| 2024 |
576 |
$6K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
2,619 |
2,354 |
$18K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
973 |
904 |
$14K |
| V2100 |
Lens spher single plano 4.00 |
53 |
53 |
$832.86 |
| V2784 |
Lens polycarb or equal |
725 |
606 |
$641.00 |
| V2750 |
Anti-reflective coating |
750 |
694 |
$485.00 |
| V2744 |
Tint photochromatic lens/es |
345 |
329 |
$50.00 |
| V2781 |
Progressive lens per lens |
337 |
300 |
$43.50 |
| V2702 |
Deluxe lens feature |
46 |
45 |
$0.00 |