Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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SAMS WEST INC

NPI: 1275550527 · HONOLULU, HI 96814 · Durable Medical Equipment & Medical Supplies · NPI assigned 07/16/2006

$6K
Total Medicaid Paid
375
Total Claims
369
Beneficiaries
4
Codes Billed
2018-05
First Month
2023-10
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (MGR OF GOVERNMENT CONTRACTING)
Parent OrganizationWAL-MART STORES INC
NPI Enumeration Date07/16/2006

Related Entities

Other providers sharing the same authorized official: LEVINE, LAURA

ProviderCityStateTotal Paid
SAMS WEST INC DENVER CO $9K
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
2018 116 $1K
2019 57 $760.36
2021 99 $2K
2022 48 $808.78
2023 55 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
90674 108 108 $2K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 211 205 $2K
0064A 44 44 $1K
90750 12 12 $0.00