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: 1750484713 · SAN ANTONIO, TX 78223 · Optician · NPI assigned 09/06/2006

$99K
Total Medicaid Paid
2,805
Total Claims
2,792
Beneficiaries
5
Codes Billed
2020-11
First Month
2024-11
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (MANAGER, GOV'T CONTRACTING)
Parent OrganizationWAL-MART STORES INC
NPI Enumeration Date09/06/2006

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
2020 43 $629.31
2021 579 $19K
2022 866 $31K
2023 730 $27K
2024 587 $23K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 1,206 1,206 $75K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 1,024 1,014 $17K
V2020 Frames, purchases 176 173 $3K
V2750 Anti-reflective coating, per lens 281 281 $2K
V2104 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens 118 118 $2K