Medicaid Provider Spending

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

WAL-MART STORES TEXAS, LLC

NPI: 1912088352 · TYLER, TX 75704 · Optician · NPI assigned 10/18/2006

$63K
Total Medicaid Paid
2,425
Total Claims
2,394
Beneficiaries
6
Codes Billed
2020-11
First Month
2024-11
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (MANAGER GOV CONTRACTING)
Parent OrganizationWAL-AMRT STORES INC
NPI Enumeration Date10/18/2006

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 57 $1K
2021 709 $18K
2022 929 $25K
2023 622 $16K
2024 108 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 547 544 $37K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 669 661 $11K
V2020 Frames, purchases 536 522 $8K
V2750 Anti-reflective coating, per lens 561 556 $5K
V2100 Sphere, single vision, plano to plus or minus 4.00, per lens 75 75 $1K
V2104 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens 37 36 $535.48