WAL-MART STORES TEXAS, LLC
NPI: 1669555272
· FT WORTH, TX 76111
· 156FX1800X
$229K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
810 |
$12K |
| 2021 |
4,419 |
$66K |
| 2022 |
4,036 |
$61K |
| 2023 |
3,411 |
$55K |
| 2024 |
2,234 |
$36K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
5,785 |
5,753 |
$106K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
3,647 |
3,629 |
$71K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
1,422 |
1,415 |
$25K |
| V2100 |
Lens spher single plano 4.00 |
909 |
903 |
$14K |
| V2750 |
Anti-reflective coating |
2,583 |
2,571 |
$7K |
| V2105 |
Spherocylinder 4.00d/4.25-6d |
187 |
187 |
$3K |
| V2107 |
Spherocylinder 4.25d/12-2d |
78 |
77 |
$1K |
| V2744 |
Tint photochromatic lens/es |
145 |
144 |
$1K |
| V2784 |
Lens polycarb or equal |
42 |
42 |
$427.00 |
| V2799 |
Misc vision item or service |
112 |
110 |
$0.00 |