Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › NJ › TETERBORO › WAL-MART STORES EAST, LP

WAL-MART STORES EAST, LP

NPI: 1851782387 · TETERBORO, NJ 07608 · Eyewear Supplier · NPI assigned 02/05/2015

$6K
Total Medicaid Paid
622
Total Claims
608
Beneficiaries
5
Codes Billed
2021-07
First Month
2024-05
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (DIRECTOR)
Parent OrganizationWAL-MART STORES INC
NPI Enumeration Date02/05/2015

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 78 $1K
2022 112 $904.00
2023 302 $2K
2024 130 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2020 Frames, purchases 295 293 $3K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 77 70 $1K
V2100 Sphere, single vision, plano to plus or minus 4.00, per lens 44 42 $902.50
V2025 Deluxe frame 190 190 $0.00
V2750 Anti-reflective coating, per lens 16 13 $0.00