WAL-MART STORES TEXAS, LP
NPI: 1619059763
· GARLAND, TX 75041
· 332H00000X
$159K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
873 |
$25K |
| 2021 |
2,127 |
$59K |
| 2022 |
2,297 |
$35K |
| 2023 |
1,539 |
$26K |
| 2024 |
759 |
$14K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
2,831 |
2,778 |
$108K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,607 |
1,577 |
$27K |
| V2750 |
Anti-reflective coating |
1,634 |
1,609 |
$11K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
611 |
598 |
$9K |
| V2100 |
Lens spher single plano 4.00 |
126 |
126 |
$2K |
| V2744 |
Tint photochromatic lens/es |
363 |
355 |
$1K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
27 |
27 |
$360.41 |
| V2799 |
Misc vision item or service |
396 |
349 |
$162.03 |