WAL-MART STORES EAST, LP
NPI: 1952484164
· BEAVER DAM, WI 53916
· Optician
· NPI assigned 10/23/2006
$914.00
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 |
|---|
| 2022 |
12 |
$159.00 |
| 2023 |
67 |
$755.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
56 |
53 |
$814.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
23 |
14 |
$100.00 |