WAL-MART STORES, INC.
NPI: 1710362918
· SILVIS, IL 61282
· Optician
· NPI assigned 07/29/2015
$206.00
Total Medicaid Paid
Provider Details
| Authorized Official | LEVINE, LAURA (DIR HEALTHCARE ENROLLMENT&CONTRACTI) |
| Parent Organization | WAL-MART STORES, INC. |
| NPI Enumeration Date | 07/29/2015 |
Related Entities
Other providers sharing the same authorized official: LEVINE, LAURA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
14 |
$206.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
14 |
14 |
$206.00 |