WAL-MART STORES EAST, LP
NPI: 1043375868
· JOHNSON CITY, TN 37604
· Optician
· NPI assigned 12/22/2006
$718.15
Total Medicaid Paid
1,740
Beneficiary Records
Provider Details
| Authorized Official | RICE, BJ (PROVIDER ENROLLMENT SPECIALIST) |
| NPI Enumeration Date | 12/22/2006 |
Related Entities
Other providers sharing the same authorized official: RICE, BJ
| Provider | City | State | Total Paid |
|---|
| WAL-MART STORES EAST, LP |
WHITEHALL |
OH |
$295K |
| WAL-MART STORES EAST, LP |
KANSAS CITY |
MO |
$267K |
| WAL-MART STORES EAST, LP |
COLUMBUS |
OH |
$229K |
| WAL-MART STORES EAST, LP |
HANOVER |
PA |
$103K |
| WAL-MART STORES EAST, LP |
NASHVILLE |
TN |
$67K |
| WAL-MART STORES, INC. |
LAS VEGAS |
NV |
$39K |
| WAL-MART STORES EAST, LP |
MATHEWS |
LA |
$36K |
| WAL-MART STORES, INC. |
WASHINGTON |
MO |
$2K |
| WAL-MART STORES EAST, LP |
MACCLENNY |
FL |
$470.00 |
| WAL-MART STORES EAST, LP |
OOLTEWAH |
TN |
$291.05 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
12 |
$54.45 |
| 2019 |
71 |
$125.45 |
| 2020 |
118 |
$72.00 |
| 2021 |
353 |
$83.90 |
| 2022 |
370 |
$58.00 |
| 2023 |
724 |
$250.35 |
| 2024 |
457 |
$74.00 |
Billing Codes
| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| V2020 |
Frames, purchases |
896 |
734 |
$605.15 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
545 |
423 |
$93.00 |
| V2750 |
Anti-reflective coating, per lens |
397 |
343 |
$20.00 |
| V2781 |
Progressive lens, per lens |
135 |
124 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
132 |
116 |
$0.00 |