Medicaid Provider Spending

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

WAL-MART STORE TEXAS, LLC

NPI: 1376674630 · FRISCO, TX 75034 · Optician · NPI assigned 03/08/2007

$4K
Total Medicaid Paid
385
Total Claims
378
Beneficiaries
3
Codes Billed
2020-10
First Month
2022-09
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (MANAGER GOV CONTRACTING)
Parent OrganizationWAL-MART STORES INC
NPI Enumeration Date03/08/2007

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
2020 29 $469.00
2021 190 $2K
2022 166 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2020 Frames, purchases 238 232 $4K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 25 25 $449.00
V2750 Anti-reflective coating, per lens 122 121 $40.00