Medicaid Provider Spending

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

WAL-MART STORES TEXAS LLC

NPI: 1922429836 · MANOR, TX 78653 · Optician · NPI assigned 12/18/2013

$2K
Total Medicaid Paid
81
Total Claims
77
Beneficiaries
4
Codes Billed
2021-07
First Month
2023-07
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (DIRECTOR GOVERNMENT CONTRACTACTING)
Parent OrganizationWAL-MART STORES INC
NPI Enumeration Date12/18/2013

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
2021 13 $203.08
2022 15 $529.00
2023 53 $2K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 15 15 $975.53
V2750 Anti-reflective coating, per lens 38 37 $549.57
V2020 Frames, purchases 15 12 $529.00
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 13 13 $225.08