Medicaid Provider Spending

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

WAL-MART STORES TEXAS, LLC

NPI: 1477993954 · SAN ANTONIO, TX 78251 · Optician · NPI assigned 06/28/2013

$16K
Total Medicaid Paid
406
Total Claims
404
Beneficiaries
4
Codes Billed
2020-12
First Month
2023-11
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (MGR. GOVERNMENT CONTRACTS)
Parent OrganizationWAL-MART STORES, INC
NPI Enumeration Date06/28/2013

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 26 $394.76
2021 105 $2K
2022 137 $7K
2023 138 $6K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 149 149 $12K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 149 148 $2K
V2020 Frames, purchases 78 77 $1K
V2750 Anti-reflective coating, per lens 30 30 $271.02