NPI: 1194816355 · PALMHURST, TX 78573 · Optician · NPI assigned 09/27/2006
| Authorized Official | LEVINE, LAURA (MANAGER GOV CONTRACTING) |
| Parent Organization | WAL-MART STORES INC |
| NPI Enumeration Date | 09/27/2006 |
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 |
|---|---|---|
| 2020 | 117 | $4K |
| 2021 | 553 | $21K |
| 2022 | 577 | $24K |
| 2023 | 520 | $23K |
| 2024 | 298 | $15K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2025 | Deluxe frame | 961 | 960 | $71K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 635 | 624 | $10K |
| V2750 | Anti-reflective coating, per lens | 320 | 319 | $3K |
| V2020 | Frames, purchases | 94 | 91 | $1K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 29 | 29 | $619.46 |
| V2104 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens | 14 | 14 | $170.00 |
| V2744 | Tint, photochromatic, per lens | 12 | 12 | $138.25 |