Medicaid Provider Spending

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

WAL-MART STORES EAST, LP

NPI: 1053869362 · MOON TOWNSHIP, PA 15108 · Optician · NPI assigned 09/15/2016

$46K
Total Medicaid Paid
1,219
Total Claims
980
Beneficiaries
5
Codes Billed
2020-10
First Month
2024-09
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (DIR HEALTHCARE CONTRACT & ENROLL)
Parent OrganizationWAL-MART STORES, INC.
NPI Enumeration Date09/15/2016

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 135 $3K
2021 536 $18K
2022 449 $20K
2023 45 $2K
2024 54 $3K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 486 380 $29K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 280 234 $8K
V2020 Frames, purchases 301 245 $5K
V2100 Sphere, single vision, plano to plus or minus 4.00, per lens 108 84 $4K
V2750 Anti-reflective coating, per lens 44 37 $294.90