WAL-MART STORES TEXAS, LP
NPI: 1700989639
· WESLACO, TX 78596
· 156FX1800X
$125K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
165 |
$6K |
| 2021 |
945 |
$32K |
| 2022 |
958 |
$33K |
| 2023 |
809 |
$31K |
| 2024 |
569 |
$23K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Eyeglasses delux frames |
1,418 |
1,415 |
$96K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,040 |
1,034 |
$17K |
| V2750 |
Anti-reflective coating |
598 |
598 |
$6K |
| V2100 |
Lens spher single plano 4.00 |
137 |
137 |
$2K |
| V2020 |
Vision svcs frames purchases |
130 |
128 |
$2K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
42 |
42 |
$690.08 |
| V2784 |
Lens polycarb or equal |
69 |
68 |
$576.34 |
| V2744 |
Tint photochromatic lens/es |
12 |
12 |
$193.81 |