Medicaid Provider Spending

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

WAL-MART STORES TEXAS LLC

NPI: 1881949667 · MISSOURI CITY, TX 77459 · Optician · NPI assigned 07/18/2012

$124K
Total Medicaid Paid
4,035
Total Claims
3,975
Beneficiaries
6
Codes Billed
2020-10
First Month
2024-11
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (ENROLLMENT SPECIALIST)
Parent OrganizationWAL-MART STORES INC
NPI Enumeration Date07/18/2012

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 173 $3K
2021 812 $20K
2022 1,068 $34K
2023 1,152 $38K
2024 830 $29K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 1,328 1,318 $78K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 1,021 1,002 $17K
V2100 Sphere, single vision, plano to plus or minus 4.00, per lens 764 750 $15K
V2020 Frames, purchases 873 856 $13K
V2104 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens 31 31 $429.70
V2750 Anti-reflective coating, per lens 18 18 $90.00