Medicaid Provider Spending

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

WAL-MART STORES TEXAS, LLC

NPI: 1912445487 · CASTROVILLE, TX 78009 · Optician · NPI assigned 02/06/2017

$2K
Total Medicaid Paid
40
Total Claims
39
Beneficiaries
2
Codes Billed
2020-11
First Month
2020-12
Last Month

Provider Details

Authorized OfficialFISHER, KYLEE (MANAGER)
Parent OrganizationWAL-MART STORES, INC
NPI Enumeration Date02/06/2017

Related Entities

Other providers sharing the same authorized official: FISHER, KYLEE

ProviderCityStateTotal Paid
WAL-MART STORES TEXAS, LLC GRAND PRAIRIE TX $128K
WAL-MART STORES TEXAS, LLC KATY TX $122K
WAL-MART STORES TEXAS, LLC ANNA TX $27K
WAL-MART STORES TEXAS, LLC TYLER TX $1K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 40 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 26 26 $1K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 14 13 $201.00