Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › TX › DONNA › WAL-MART STORES TEXAS, LLC

WAL-MART STORES TEXAS, LLC

NPI: 1023409976 · DONNA, TX 78537 · Optician · NPI assigned 02/13/2015

$44K
Total Medicaid Paid
1,172
Total Claims
1,151
Beneficiaries
5
Codes Billed
2020-11
First Month
2024-11
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (DIRECTOR OF HEALTHCARE CONTRACTING)
Parent OrganizationWAL-MART STORES, INC
NPI Enumeration Date02/13/2015

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
2020 86 $3K
2021 215 $5K
2022 329 $13K
2023 303 $15K
2024 239 $9K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 443 436 $35K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 314 308 $5K
V2750 Anti-reflective coating, per lens 265 262 $2K
V2020 Frames, purchases 136 133 $2K
V2104 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens 14 12 $207.40