NPI: 1366545899 · BROWNSVILLE, TX 78521 · Optician · NPI assigned 09/07/2006
| Authorized Official | LEVINE, LAURA (MGR GOV CONTRACTING) |
| Parent Organization | WAL-MART STORES INC |
| NPI Enumeration Date | 09/07/2006 |
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 |
|---|---|---|
| 2021 | 100 | $5K |
| 2022 | 870 | $28K |
| 2023 | 969 | $35K |
| 2024 | 475 | $19K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2025 | Deluxe frame | 833 | 827 | $64K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 659 | 640 | $10K |
| V2020 | Frames, purchases | 385 | 381 | $7K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 172 | 170 | $3K |
| V2750 | Anti-reflective coating, per lens | 260 | 258 | $2K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 78 | 78 | $667.09 |
| V2104 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens | 27 | 27 | $429.25 |