Medicaid Provider Spending

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

WAL-MART STORES TEXAS LP

NPI: 1073936050 · SAN ANTONIO, TX 78218 · Optician · NPI assigned 01/28/2014

$26K
Total Medicaid Paid
773
Total Claims
759
Beneficiaries
3
Codes Billed
2020-11
First Month
2024-11
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (DIRECTOR OF GOVERNMENT CONTRACTING)
Parent OrganizationWAL-MART STORES INC
NPI Enumeration Date01/28/2014

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 31 $936.87
2021 123 $4K
2022 233 $7K
2023 226 $8K
2024 160 $6K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 361 358 $20K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 225 216 $3K
V2750 Anti-reflective coating, per lens 187 185 $2K