WAL-MART STORES EAST, LP
NPI: 1750464095
· RIO RANCHO, NM 87124
· Optician
· NPI assigned 10/23/2006
$714.50
Total Medicaid Paid
Provider Details
| Authorized Official | EPPERSON, LINDA (NPI COORDINATOR) |
| NPI Enumeration Date | 10/23/2006 |
Related Entities
Other providers sharing the same authorized official: EPPERSON, LINDA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
| 2021 |
27 |
$471.50 |
| 2023 |
14 |
$243.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
| V2020 |
Frames, purchases |
29 |
29 |
$478.50 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$236.00 |