Medicaid Provider Spending

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

WAL-MART STORES EAST, LP

NPI: 1184032021 · BOCA RATON, FL 33428 · Optician · NPI assigned 07/23/2014

$366.00
Total Medicaid Paid
53
Total Claims
26
Beneficiaries
2
Codes Billed
2021-11
First Month
2021-11
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (DIR. HEALTHCARE CONTRACT&PLAN ENROL)
Parent OrganizationWAL-MART STORES, INC
NPI Enumeration Date07/23/2014

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
2021 53 $366.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2020 Frames, purchases 23 14 $240.00
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 30 12 $126.00