Medicaid Provider Spending

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

WAL-MART STORES EAST, LP

NPI: 1326419946 · HIGH RIDGE, MO 63049 · Optician · NPI assigned 10/08/2015

$9K
Total Medicaid Paid
375
Total Claims
375
Beneficiaries
4
Codes Billed
2018-03
First Month
2024-08
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (DIR HEALTHCARE AND ENROLLMENT)
NPI Enumeration Date10/08/2015

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
2018 12 $224.00
2019 66 $962.00
2020 31 $460.20
2021 31 $1K
2022 75 $1K
2023 89 $4K
2024 71 $528.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2020 Frames, purchases 247 247 $5K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient 42 42 $3K
V2100 Sphere, single vision, plano to plus or minus 4.00, per lens 47 47 $544.50
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 39 39 $368.50