WAL-MART STORES, INC
NPI: 1609090091
· COLLINSVILLE, IL 62234
· Optician
· NPI assigned 04/13/2007
$927.00
Total Medicaid Paid
Provider Details
| Authorized Official | DOUGLAS, SHIELA (NPI ASSOCIATE) |
| NPI Enumeration Date | 04/13/2007 |
Related Entities
Other providers sharing the same authorized official: DOUGLAS, SHIELA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
51 |
$927.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
22 |
22 |
$464.00 |
| V2020 |
Frames, purchases |
17 |
17 |
$344.00 |
| V2025 |
Deluxe frame |
12 |
12 |
$119.00 |