Medicaid Provider Spending

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

WAL-MART STORES TEXAS, LLC

NPI: 1366536385 · PORTLAND, TX 78374 · Optician · NPI assigned 10/03/2006

$5K
Total Medicaid Paid
71
Total Claims
71
Beneficiaries
2
Codes Billed
2021-03
First Month
2023-08
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (MANAGER, GOV'T CONTRACTING)
Parent OrganizationWAL-MART STORES, INC
NPI Enumeration Date10/03/2006

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
2021 29 $2K
2022 12 $982.49
2023 30 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 57 57 $5K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 14 14 $270.00