Medicaid Provider Spending

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

WAL-MART STORES TEXAS, LLC

NPI: 1225468135 · SAN ANTONIO, TX 78217 · Optician · NPI assigned 11/14/2013

$9K
Total Medicaid Paid
151
Total Claims
151
Beneficiaries
3
Codes Billed
2020-12
First Month
2024-03
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (DIR., GOVERNMENT CONTRACTING)
Parent OrganizationWAL-MART STORES, INC
NPI Enumeration Date11/14/2013

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
2020 12 $858.27
2021 26 $2K
2022 13 $880.79
2023 75 $4K
2024 25 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 122 122 $9K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 15 15 $268.16
V2750 Anti-reflective coating, per lens 14 14 $108.40