WAL-MART STORES EAST, LP
NPI: 1942382833
· SAINT CHARLES, MO 63303
· 156FX1800X
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
40 |
$708.50 |
| 2022 |
57 |
$1K |
| 2023 |
137 |
$6K |
| 2024 |
110 |
$1K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
73 |
73 |
$4K |
| V2020 |
Vision svcs frames purchases |
217 |
217 |
$4K |
| V2100 |
Lens spher single plano 4.00 |
42 |
42 |
$534.00 |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
12 |
12 |
$217.50 |