Medicaid Provider Spending

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

WAL-MART STORES TEXAS, LLC

NPI: 1497803092 · LUBBOCK, TX 79424 · Optician · NPI assigned 01/08/2007

$3K
Total Medicaid Paid
155
Total Claims
142
Beneficiaries
4
Codes Billed
2021-03
First Month
2023-09
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (MANAGER, GOV'T CONTRACTING)
Parent OrganizationWAL-MART STORES INC
NPI Enumeration Date01/08/2007

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
2021 24 $245.38
2022 42 $1K
2023 89 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2750 Anti-reflective coating, per lens 84 80 $904.60
V2025 Deluxe frame 13 12 $799.97
V2020 Frames, purchases 30 25 $513.35
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 28 25 $442.36