Medicaid Provider Spending

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

WAL-MART STORES TEXAS, LLC

NPI: 1093000275 · FLORESVILLE, TX 78114 · Optician · NPI assigned 06/15/2011

$4K
Total Medicaid Paid
90
Total Claims
90
Beneficiaries
2
Codes Billed
2020-11
First Month
2023-07
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (MGR GOV CONTRACTING)
Parent OrganizationWAL-MART STORES, INC
NPI Enumeration Date06/15/2011

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 14 $789.00
2022 48 $2K
2023 28 $949.28

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 62 62 $4K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 28 28 $439.34