Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › MO › FLORISSANT › WAL-MART STORES EAST, LP

WAL-MART STORES EAST, LP

NPI: 1013396191 · FLORISSANT, MO 63033 · Optician · NPI assigned 05/22/2015

$565.20
Total Medicaid Paid
38
Total Claims
38
Beneficiaries
2
Codes Billed
2021-07
First Month
2021-08
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (DIRECTOR)
Parent OrganizationWAL-MART STORES, INC
NPI Enumeration Date05/22/2015

Related Entities

Other providers sharing the same authorized official: LEVINE, LAURA

ProviderCityStateTotal Paid
SAMS WEST INC DENVER CO $9K
SAMS WEST INC HONOLULU HI $6K
SAMS WEST INC AURORA CO $1K
SAMS EAST INC WINSTON SALEM NC $715.00
SAMS WEST INC RENO NV $0.00
SAMS EAST INC METAIRIE LA $0.00

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 38 $565.20

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2020 Frames, purchases 25 25 $507.20
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 13 13 $58.00