WAL-MART STORES TEXAS, LLC
NPI: 1376973115
· HOUSTON, TX 77023
· 156FX1800X
$515K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
171 |
$5K |
| 2020 |
751 |
$19K |
| 2021 |
4,927 |
$117K |
| 2022 |
5,113 |
$127K |
| 2023 |
4,889 |
$138K |
| 2024 |
3,773 |
$107K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Eyeglasses delux frames |
5,034 |
5,026 |
$327K |
| V2100 |
Lens spher single plano 4.00 |
2,972 |
2,955 |
$55K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
3,371 |
3,323 |
$54K |
| V2020 |
Vision svcs frames purchases |
2,257 |
2,214 |
$35K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
982 |
974 |
$14K |
| V2750 |
Anti-reflective coating |
2,864 |
2,849 |
$13K |
| V2744 |
Tint photochromatic lens/es |
1,030 |
1,022 |
$9K |
| V2784 |
Lens polycarb or equal |
507 |
503 |
$4K |
| V2107 |
Spherocylinder 4.25d/12-2d |
138 |
137 |
$2K |
| V2799 |
Misc vision item or service |
408 |
358 |
$2K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
61 |
59 |
$806.55 |