Medicaid Provider Spending

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

WAL-MART STORES TEXAS, LLC

NPI: 1700985801 · PEARLAND, TX 77581 · Optician · NPI assigned 09/22/2006

$105K
Total Medicaid Paid
3,520
Total Claims
3,504
Beneficiaries
6
Codes Billed
2019-08
First Month
2024-11
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (MGR GOV CONTRACTING)
Parent OrganizationWAL-MART STORES INC
NPI Enumeration Date09/22/2006

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
2019 13 $165.00
2020 211 $5K
2021 1,228 $36K
2022 1,028 $31K
2023 605 $19K
2024 435 $13K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 1,149 1,148 $76K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 711 707 $12K
V2100 Sphere, single vision, plano to plus or minus 4.00, per lens 409 406 $8K
V2020 Frames, purchases 258 254 $4K
V2750 Anti-reflective coating, per lens 906 902 $4K
V2104 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens 87 87 $1K