WAL-MART STORES TEXAS, LP
NPI: 1346322245
· MANSFIELD, TX 76063
· 156FX1800X
$125K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
274 |
$3K |
| 2021 |
1,385 |
$19K |
| 2022 |
1,771 |
$26K |
| 2023 |
1,878 |
$39K |
| 2024 |
1,499 |
$38K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
2,837 |
2,771 |
$72K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,914 |
1,870 |
$37K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
484 |
474 |
$8K |
| V2750 |
Anti-reflective coating |
1,356 |
1,325 |
$6K |
| V2100 |
Lens spher single plano 4.00 |
145 |
142 |
$2K |
| V2744 |
Tint photochromatic lens/es |
54 |
52 |
$224.00 |
| V2799 |
Misc vision item or service |
17 |
15 |
$0.00 |