Medicaid Provider Spending

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

WAL-MART STORES TEXAS, LLC

NPI: 1437540150 · LOS FRESNOS, TX 78566 · Optician · NPI assigned 02/17/2015

$10K
Total Medicaid Paid
192
Total Claims
188
Beneficiaries
3
Codes Billed
2021-03
First Month
2024-04
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (DIRECTOR OF HEALTHCARE CONTRACTING)
Parent OrganizationWAL-MART STORES, INC
NPI Enumeration Date02/17/2015

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
2021 51 $2K
2023 109 $6K
2024 32 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 120 120 $9K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 32 30 $503.32
V2750 Anti-reflective coating, per lens 40 38 $326.71