Medicaid Provider Spending

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

WAL-MART STORES TEXAS, LLC

NPI: 1649351172 · DALLAS, TX 75248 · Optician · NPI assigned 10/18/2006

$5K
Total Medicaid Paid
259
Total Claims
254
Beneficiaries
3
Codes Billed
2021-07
First Month
2023-08
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (MANAGER OF GOV CONTRACTING)
Parent OrganizationWAL-MART STORES INC
NPI Enumeration Date10/18/2006

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 80 $3K
2022 117 $2K
2023 62 $486.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2020 Frames, purchases 144 139 $4K
V2750 Anti-reflective coating, per lens 99 99 $802.00
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 16 16 $313.00