Medicaid Provider Spending

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

WAL-MART STORES TEXAS, LLC

NPI: 1760806806 · BRYAN, TX 77807 · Optician · NPI assigned 02/10/2014

$7K
Total Medicaid Paid
260
Total Claims
252
Beneficiaries
4
Codes Billed
2021-04
First Month
2024-09
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (DIRECTOR OF GOVERNMENT CONTRACTING)
Parent OrganizationWAL-MART STORES, INC
NPI Enumeration Date02/10/2014

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
2021 13 $161.50
2022 95 $3K
2023 137 $4K
2024 15 $337.82

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2020 Frames, purchases 84 78 $3K
V2750 Anti-reflective coating, per lens 131 129 $2K
V2025 Deluxe frame 13 13 $782.94
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 32 32 $479.82