Medicaid Provider Spending

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

WAL-MART STORES EAST, LP

NPI: 1174989305 · JACKSONVILLE, FL 32244 · Optician · NPI assigned 01/04/2016

$4K
Total Medicaid Paid
575
Total Claims
257
Beneficiaries
2
Codes Billed
2022-02
First Month
2024-07
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (DIR HEALTHCARE CONTRACT & ENROLL)
Parent OrganizationWAL-MART STORES, INC.
NPI Enumeration Date01/04/2016

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
2022 269 $2K
2023 120 $1K
2024 186 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2020 Frames, purchases 445 202 $2K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 130 55 $2K