Medicaid Provider Spending

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

WAL-MART STORES TEXAS, LLC

NPI: 1992256325 · TOMBALL, TX 77375 · Optician · NPI assigned 10/20/2016

$22K
Total Medicaid Paid
619
Total Claims
618
Beneficiaries
4
Codes Billed
2020-12
First Month
2024-09
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (DIR HEALTHCARE CONTRACT&ENROLLMEN)
Parent OrganizationWAL-MART STORES, INC.
NPI Enumeration Date10/20/2016

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 41 $1K
2021 74 $2K
2022 213 $7K
2023 216 $8K
2024 75 $3K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 255 255 $18K
V2100 Sphere, single vision, plano to plus or minus 4.00, per lens 101 101 $2K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 63 62 $1K
V2750 Anti-reflective coating, per lens 200 200 $521.92