Medicaid Provider Spending

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

WAL-MART STORES TEXAS LLC

NPI: 1417224148 · DALLAS, TX 75243 · Optician · NPI assigned 11/23/2011

$11K
Total Medicaid Paid
424
Total Claims
404
Beneficiaries
4
Codes Billed
2020-01
First Month
2021-03
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (MANAGER, GOV'T CONTRACTING)
Parent OrganizationWAL-MART STORES INC
NPI Enumeration Date11/23/2011

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 184 $5K
2021 240 $6K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2020 Frames, purchases 191 183 $7K
V2750 Anti-reflective coating, per lens 104 100 $2K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 98 93 $2K
V2104 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens 31 28 $471.00