WAL-MART STORES EAST, LP
NPI: 1114082997
· MACCLENNY, FL 36063
· Optician
· NPI assigned 12/22/2006
$470.00
Total Medicaid Paid
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 |
JOHNSON CITY |
TN |
$718.15 |
| WAL-MART STORES EAST, LP |
OOLTEWAH |
TN |
$291.05 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
48 |
$470.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
48 |
26 |
$470.00 |