WAL-MART STORES EAST, LP
NPI: 1972672947
· INDIANA, PA 15701
· 156FX1800X
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
98 |
$3K |
| 2021 |
967 |
$22K |
| 2022 |
573 |
$13K |
| 2023 |
301 |
$6K |
| 2024 |
649 |
$22K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2103 |
Spherocylindr 4.00d/12-2.00d |
648 |
551 |
$22K |
| V2020 |
Vision svcs frames purchases |
1,416 |
1,228 |
$21K |
| V2025 |
Eyeglasses delux frames |
250 |
250 |
$14K |
| V2100 |
Lens spher single plano 4.00 |
197 |
163 |
$8K |
| V2781 |
Progressive lens per lens |
14 |
12 |
$1K |
| V2750 |
Anti-reflective coating |
63 |
60 |
$399.00 |