NPI: 1194164996 · SWEETWATER, TN 37874 · Optician · NPI assigned 06/14/2013
| Authorized Official | LEVINE, LAURA (MGR GOV CONTRACTING) |
| Parent Organization | WAL-MART STORES, INC |
| NPI Enumeration Date | 06/14/2013 |
Other providers sharing the same authorized official: LEVINE, LAURA
| Provider | City | State | Total 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 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 431 | $865.05 |
| 2019 | 177 | $115.45 |
| 2020 | 39 | $0.00 |
| 2022 | 100 | $1K |
| 2023 | 111 | $877.90 |
| 2024 | 133 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Frames, purchases | 644 | 623 | $3K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 54 | 54 | $1K |
| V2750 | Anti-reflective coating, per lens | 68 | 68 | $0.00 |
| V2203 | Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 18 | 18 | $0.00 |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 127 | 122 | $0.00 |
| V2744 | Tint, photochromatic, per lens | 37 | 37 | $0.00 |
| V2781 | Progressive lens, per lens | 43 | 43 | $0.00 |