WAL-MART STORES TEXAS, LP
NPI: 1235221888
· PASADENA, TX 77506
· 156FX1800X
$527K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
87 |
$2K |
| 2020 |
1,056 |
$24K |
| 2021 |
5,162 |
$123K |
| 2022 |
5,310 |
$131K |
| 2023 |
5,147 |
$142K |
| 2024 |
3,736 |
$106K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Eyeglasses delux frames |
5,259 |
5,250 |
$337K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
3,132 |
3,097 |
$52K |
| V2100 |
Lens spher single plano 4.00 |
2,737 |
2,713 |
$52K |
| V2020 |
Vision svcs frames purchases |
1,671 |
1,640 |
$26K |
| V2750 |
Anti-reflective coating |
3,964 |
3,944 |
$20K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
1,157 |
1,141 |
$17K |
| V2744 |
Tint photochromatic lens/es |
918 |
915 |
$9K |
| V2784 |
Lens polycarb or equal |
692 |
685 |
$6K |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
296 |
292 |
$4K |
| V2799 |
Misc vision item or service |
561 |
494 |
$3K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
60 |
59 |
$914.11 |
| V2107 |
Spherocylinder 4.25d/12-2d |
24 |
24 |
$303.57 |
| V2702 |
Deluxe lens feature |
27 |
27 |
$141.07 |