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: 1538474283 · SAN ANTONIO, TX 78229 · Optician · NPI assigned 08/18/2010

$35K
Total Medicaid Paid
1,118
Total Claims
1,114
Beneficiaries
3
Codes Billed
2020-11
First Month
2023-11
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (MGR GOV CONTRACTING)
Parent OrganizationWAL-MART STORES INC
NPI Enumeration Date08/18/2010

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 $717.14
2021 436 $13K
2022 520 $16K
2023 136 $6K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 441 439 $27K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 310 308 $5K
V2750 Anti-reflective coating, per lens 367 367 $3K