WAL-MART STORES EAST, LP
NPI: 1730570540
· MURFREESBORO, TN 37127
· Optician
· NPI assigned 02/16/2015
$286.50
Total Medicaid Paid
Provider Details
| Authorized Official | LEVINE, LAURA (DIRECTOR, OF HEALTHCARE CONTRACTING) |
| Parent Organization | WAL-MART STORES, INC. |
| NPI Enumeration Date | 02/16/2015 |
Related Entities
Other providers sharing the same authorized official: LEVINE, LAURA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2023 |
42 |
$286.50 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$207.50 |
| V2020 |
Frames, purchases |
17 |
15 |
$79.00 |
| V2750 |
Anti-reflective coating, per lens |
13 |
12 |
$0.00 |