WAL-MART STORES TEXAS, LP
NPI: 1255412268
· NORTH RICHLAND HILLS, TX 76180
· 156FX1800X
$166K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
638 |
$9K |
| 2021 |
3,009 |
$42K |
| 2022 |
2,696 |
$36K |
| 2023 |
2,937 |
$47K |
| 2024 |
1,804 |
$32K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
4,105 |
4,074 |
$80K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,516 |
2,501 |
$48K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
985 |
975 |
$16K |
| V2100 |
Lens spher single plano 4.00 |
598 |
592 |
$10K |
| V2750 |
Anti-reflective coating |
2,120 |
2,111 |
$6K |
| V2107 |
Spherocylinder 4.25d/12-2d |
155 |
153 |
$3K |
| V2744 |
Tint photochromatic lens/es |
372 |
372 |
$1K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
74 |
72 |
$1K |
| V2784 |
Lens polycarb or equal |
112 |
112 |
$877.09 |
| V2799 |
Misc vision item or service |
47 |
46 |
$0.00 |