NPI: 1265802730 · HAMBURG, PA 19526 · Optician · NPI assigned 09/28/2015
| Authorized Official | LEVINE, LAURA (DIR HEALTHCARE CONTRACT & ENROLL) |
| Parent Organization | WAL-MART STORES, INC. |
| NPI Enumeration Date | 09/28/2015 |
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 | 331 | $9K |
| 2021 | 1,375 | $36K |
| 2022 | 1,323 | $35K |
| 2023 | 1,112 | $28K |
| 2024 | 345 | $9K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Frames, purchases | 2,168 | 1,684 | $53K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 1,515 | 765 | $45K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 510 | 255 | $16K |
| V2200 | Sphere, bifocal, plano to plus or minus 4.00d, per lens | 51 | 27 | $2K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 216 | 106 | $193.00 |
| V2781 | Progressive lens, per lens | 26 | 14 | $153.00 |