Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › PA › SAYRE › WAL-MART STORES EAST, LP

WAL-MART STORES EAST, LP

NPI: 1558788521 · SAYRE, PA 18840 · Optician · NPI assigned 03/27/2014

$40K
Total Medicaid Paid
1,656
Total Claims
1,037
Beneficiaries
3
Codes Billed
2020-12
First Month
2024-11
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (DIR HEALTHCARE CONTRACT & ENROLLMEN)
Parent OrganizationWAL-MART STORES, INC.
NPI Enumeration Date03/27/2014

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 14 $362.88
2021 155 $4K
2022 390 $9K
2023 990 $23K
2024 107 $3K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2020 Frames, purchases 756 611 $20K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 674 317 $18K
V2784 Lens, polycarbonate or equal, any index, per lens 226 109 $607.00