Medicaid Provider Spending

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

WAL-MART STORES EAST, LP

NPI: 1255874970 · LEES SUMMIT, MO 64082 · Optician · NPI assigned 11/29/2016

$9K
Total Medicaid Paid
476
Total Claims
476
Beneficiaries
5
Codes Billed
2020-09
First Month
2024-10
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (DIR HEALTHCARE CONTRACTING)
Parent OrganizationWAL-MART STORES, INC
NPI Enumeration Date11/29/2016

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
2020 15 $770.25
2021 127 $3K
2022 164 $3K
2023 25 $940.13
2024 145 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2020 Frames, purchases 333 333 $5K
92002 37 37 $1K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 15 15 $770.25
V2100 Sphere, single vision, plano to plus or minus 4.00, per lens 52 52 $639.00
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 39 39 $436.50