WAL-MART STORES TEXAS, LP
NPI: 1437258332
· PASADENA, TX 77505
· 156FX1800X
$497K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
608 |
$17K |
| 2021 |
4,380 |
$121K |
| 2022 |
4,563 |
$125K |
| 2023 |
4,299 |
$129K |
| 2024 |
3,230 |
$105K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Eyeglasses delux frames |
4,654 |
4,650 |
$340K |
| V2100 |
Lens spher single plano 4.00 |
2,669 |
2,655 |
$50K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
2,702 |
2,681 |
$44K |
| V2020 |
Vision svcs frames purchases |
1,494 |
1,469 |
$24K |
| V2750 |
Anti-reflective coating |
3,106 |
3,094 |
$13K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
887 |
881 |
$13K |
| V2784 |
Lens polycarb or equal |
616 |
611 |
$5K |
| V2744 |
Tint photochromatic lens/es |
491 |
490 |
$5K |
| V2783 |
Lens, >= 1.66 p/>=1.80 g |
158 |
158 |
$2K |
| V2799 |
Misc vision item or service |
254 |
241 |
$974.12 |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
25 |
25 |
$361.31 |
| V2107 |
Spherocylinder 4.25d/12-2d |
24 |
24 |
$338.68 |