WAL-MART STORES TEXAS, LP
NPI: 1144312794
· SUGAR LAND, TX 77478
· 156FX1800X
$261K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
451 |
$13K |
| 2021 |
2,282 |
$64K |
| 2022 |
2,243 |
$66K |
| 2023 |
2,137 |
$73K |
| 2024 |
1,227 |
$45K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Eyeglasses delux frames |
2,604 |
2,603 |
$192K |
| V2100 |
Lens spher single plano 4.00 |
1,399 |
1,394 |
$26K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,422 |
1,410 |
$23K |
| V2020 |
Vision svcs frames purchases |
537 |
525 |
$9K |
| V2750 |
Anti-reflective coating |
1,943 |
1,931 |
$6K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
200 |
198 |
$3K |
| V2799 |
Misc vision item or service |
126 |
93 |
$642.51 |
| V2107 |
Spherocylinder 4.25d/12-2d |
44 |
44 |
$545.77 |
| V2744 |
Tint photochromatic lens/es |
65 |
65 |
$346.61 |