Medicaid Provider Spending

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

WAL-MART STORES TEXAS, LLC

NPI: 1811337397 · HORIZON CITY, TX 79928 · Optician · NPI assigned 06/28/2013

$120K
Total Medicaid Paid
3,233
Total Claims
3,231
Beneficiaries
6
Codes Billed
2020-11
First Month
2024-11
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (MGR. GOVERNMENT CONTRACTS)
Parent OrganizationWAL-MART STORES, INC
NPI Enumeration Date06/28/2013

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 102 $3K
2021 747 $26K
2022 999 $36K
2023 890 $34K
2024 495 $22K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 1,254 1,254 $92K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 988 987 $15K
V2750 Anti-reflective coating, per lens 639 638 $8K
V2104 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens 230 230 $3K
V2020 Frames, purchases 109 109 $2K
V2100 Sphere, single vision, plano to plus or minus 4.00, per lens 13 13 $158.79