WAL-MART STORES TEXAS, LP
NPI: 1225111784
· FT WORTH, TX 76132
· 156FX1800X
$273K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
793 |
$11K |
| 2021 |
4,497 |
$62K |
| 2022 |
4,723 |
$69K |
| 2023 |
4,074 |
$69K |
| 2024 |
2,931 |
$62K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
6,249 |
6,174 |
$129K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
3,978 |
3,934 |
$79K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
1,400 |
1,387 |
$25K |
| V2100 |
Lens spher single plano 4.00 |
1,199 |
1,186 |
$21K |
| V2750 |
Anti-reflective coating |
2,403 |
2,385 |
$9K |
| V2107 |
Spherocylinder 4.25d/12-2d |
219 |
217 |
$4K |
| V2744 |
Tint photochromatic lens/es |
561 |
559 |
$4K |
| V2784 |
Lens polycarb or equal |
238 |
237 |
$2K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
40 |
40 |
$651.50 |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
13 |
13 |
$462.00 |
| V2799 |
Misc vision item or service |
718 |
638 |
$101.43 |