WAL-MART STORES TEXAS LLC
NPI: 1447557798
· HOUSTON, TX 77055
· Optician
· NPI assigned 02/23/2011
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | LEVINE, LAURA (MGR GOV CONTRACTING) |
| Parent Organization | WAL-MART STORES INC |
| NPI Enumeration Date | 02/23/2011 |
Related Entities
Other providers sharing the same authorized official: LEVINE, LAURA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
13 |
$0.00 |
| 2022 |
338 |
$0.00 |
| 2023 |
94 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
32 |
32 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
74 |
73 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
69 |
67 |
$0.00 |
| V2025 |
Deluxe frame |
192 |
189 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
65 |
63 |
$0.00 |
| V2020 |
Frames, purchases |
13 |
13 |
$0.00 |