WAL-MART STORES TEXAS, LP
NPI: 1063503019
· HOUSTON, TX 77015
· 156FX1800X
$599K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
1,333 |
$29K |
| 2021 |
6,852 |
$152K |
| 2022 |
6,420 |
$146K |
| 2023 |
5,826 |
$162K |
| 2024 |
3,572 |
$110K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Eyeglasses delux frames |
5,909 |
5,895 |
$394K |
| V2100 |
Lens spher single plano 4.00 |
3,078 |
3,057 |
$57K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
3,449 |
3,407 |
$56K |
| V2020 |
Vision svcs frames purchases |
1,821 |
1,776 |
$29K |
| V2750 |
Anti-reflective coating |
5,541 |
5,502 |
$21K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
1,284 |
1,268 |
$18K |
| V2744 |
Tint photochromatic lens/es |
804 |
795 |
$7K |
| V2799 |
Misc vision item or service |
995 |
952 |
$6K |
| V2784 |
Lens polycarb or equal |
563 |
557 |
$5K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
189 |
189 |
$3K |
| V2107 |
Spherocylinder 4.25d/12-2d |
133 |
132 |
$2K |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
207 |
205 |
$2K |
| V2523 |
Cntct lens hydrophil extend |
14 |
14 |
$860.00 |
| V2702 |
Deluxe lens feature |
16 |
15 |
$120.73 |