WAL-MART STORES TEXAS, LLC
NPI: 1801061668
· ARLINGTON, TX 76017
· 156FX1800X
$119K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
133 |
$2K |
| 2021 |
728 |
$11K |
| 2022 |
1,203 |
$19K |
| 2023 |
3,137 |
$55K |
| 2024 |
1,812 |
$33K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Vision svcs frames purchases |
2,728 |
2,695 |
$61K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,776 |
1,752 |
$35K |
| V2750 |
Anti-reflective coating |
1,455 |
1,432 |
$9K |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
444 |
436 |
$8K |
| V2100 |
Lens spher single plano 4.00 |
270 |
270 |
$5K |
| V2107 |
Spherocylinder 4.25d/12-2d |
74 |
74 |
$1K |
| V2784 |
Lens polycarb or equal |
34 |
34 |
$407.00 |
| V2744 |
Tint photochromatic lens/es |
56 |
56 |
$325.00 |
| V2799 |
Misc vision item or service |
176 |
150 |
$0.00 |