Medicaid Provider Spending

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

WAL-MART STORES TEXAS, LLC

NPI: 1174902027 · CIBOLO, TX 78108 · Optician · NPI assigned 05/26/2015

$4K
Total Medicaid Paid
93
Total Claims
93
Beneficiaries
3
Codes Billed
2023-08
First Month
2024-10
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (DIRECTOR)
Parent OrganizationWAL-MAT STORES, INC
NPI Enumeration Date05/26/2015

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
2023 43 $1K
2024 50 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 40 40 $3K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 40 40 $727.31
V2750 Anti-reflective coating, per lens 13 13 $135.00