Medicaid Provider Spending

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

WAL-MART STORES TEXAS, LLC

NPI: 1669504874 · LAREDO, TX 78046 · Optician · NPI assigned 03/12/2007

$90K
Total Medicaid Paid
1,990
Total Claims
1,983
Beneficiaries
6
Codes Billed
2020-11
First Month
2024-11
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (MGR GOV CONTRACTING)
Parent OrganizationWAL-MART STORES INC
NPI Enumeration Date03/12/2007

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
2020 115 $4K
2021 603 $25K
2022 541 $24K
2023 525 $25K
2024 206 $12K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 990 988 $75K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 712 709 $12K
V2020 Frames, purchases 95 95 $1K
V2750 Anti-reflective coating, per lens 128 128 $986.93
V2104 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens 53 51 $702.54
V2100 Sphere, single vision, plano to plus or minus 4.00, per lens 12 12 $237.50