Medicaid Provider Spending

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

WAL-MART STORES TEXAS, LLC

NPI: 1972943355 · FORT WORTH, TX 76052 · Optician · NPI assigned 06/28/2013

$5K
Total Medicaid Paid
339
Total Claims
335
Beneficiaries
3
Codes Billed
2021-01
First Month
2024-07
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (MGR. GOVERNMENT CONTRACTS)
Parent OrganizationWAL-MART STORES, INC
NPI Enumeration Date06/28/2013

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 107 $1K
2022 122 $1K
2023 70 $2K
2024 40 $767.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2020 Frames, purchases 181 179 $4K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 54 54 $1K
V2750 Anti-reflective coating, per lens 104 102 $505.00