WAL-MART STORES TEXAS, LLC
NPI: 1972041374
· TYLER, TX 75702
· Optician
· NPI assigned 02/06/2017
Provider Details
| Authorized Official | FISHER, KYLEE (MANAGER) |
| Parent Organization | WAL-MART STORES, INC |
| NPI Enumeration Date | 02/06/2017 |
Related Entities
Other providers sharing the same authorized official: FISHER, KYLEE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
42 |
$580.00 |
| 2023 |
40 |
$649.00 |
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 |
38 |
36 |
$625.00 |
| V2020 |
Frames, purchases |
44 |
41 |
$604.00 |