NPI: 1285795898 · MATHEWS, LA 70394 · Optician · NPI assigned 12/13/2006
| Authorized Official | RICE, BJ (PROVIDER ENROLLMENT SPECIALIST) |
| NPI Enumeration Date | 12/13/2006 |
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, INC. | WASHINGTON | MO | $2K |
| WAL-MART STORES EAST, LP | JOHNSON CITY | TN | $718.15 |
| WAL-MART STORES EAST, LP | MACCLENNY | FL | $470.00 |
| WAL-MART STORES EAST, LP | OOLTEWAH | TN | $291.05 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 113 | $1K |
| 2021 | 574 | $8K |
| 2022 | 883 | $14K |
| 2023 | 474 | $7K |
| 2024 | 424 | $6K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Frames, purchases | 1,606 | 1,440 | $20K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 674 | 623 | $13K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 130 | 117 | $2K |
| V2203 | Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 17 | 12 | $500.00 |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 41 | 41 | $48.00 |