Medicaid Provider Spending

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

WAL-MART STORES TEXAS, LLC

NPI: 1033215496 · LUMBERTON, TX 77657 · Optician · NPI assigned 09/15/2006

$11K
Total Medicaid Paid
523
Total Claims
517
Beneficiaries
6
Codes Billed
2020-12
First Month
2024-08
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (MGR GOV CONTRACTING)
Parent OrganizationWAL-MART STORES INC
NPI Enumeration Date09/15/2006

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 27 $360.50
2021 442 $8K
2022 37 $2K
2024 17 $474.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2020 Frames, purchases 338 335 $6K
V2025 Deluxe frame 37 36 $2K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 92 90 $2K
V2100 Sphere, single vision, plano to plus or minus 4.00, per lens 17 17 $474.00
V2750 Anti-reflective coating, per lens 24 24 $58.00
V2784 Lens, polycarbonate or equal, any index, per lens 15 15 $50.00