WAL-MART STORES EAST, LP
NPI: 1174605083
· ANTIGO, WI 54409
· Optician
· NPI assigned 10/19/2006
$407.00
Total Medicaid Paid
Provider Details
| Authorized Official | EPPERSON, LINDA (NPI COORDINATOR) |
| NPI Enumeration Date | 10/19/2006 |
Related Entities
Other providers sharing the same authorized official: EPPERSON, LINDA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
15 |
$190.00 |
| 2023 |
59 |
$217.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
34 |
28 |
$407.00 |
| 92015 |
Determination of refractive state |
40 |
25 |
$0.00 |