WAL-MART STORES EAST, LP
NPI: 1972684009
· DESLOGE, MO 63601
· 156FX1800X
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
534 |
$6K |
| 2019 |
371 |
$3K |
| 2020 |
71 |
$890.60 |
| 2021 |
440 |
$8K |
| 2022 |
109 |
$2K |
| 2023 |
65 |
$2K |
| 2024 |
28 |
$149.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
647 |
646 |
$13K |
| 92004 |
|
118 |
118 |
$6K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
574 |
574 |
$3K |
| 92012 |
|
12 |
12 |
$751.74 |
| V2100 |
Lens spher single plano 4.00 |
107 |
107 |
$516.91 |
| V2025 |
Eyeglasses delux frames |
160 |
160 |
$0.00 |