WAL-MART STORES TEXAS, LLC
NPI: 1861583049
· HARKER HEIGHTS, TX 76548
· 156FX1800X
$204K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
186 |
$3K |
| 2021 |
2,022 |
$52K |
| 2022 |
2,208 |
$60K |
| 2023 |
1,785 |
$54K |
| 2024 |
1,209 |
$35K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2025 |
Eyeglasses delux frames |
892 |
889 |
$59K |
| V2020 |
Vision svcs frames purchases |
1,481 |
1,388 |
$58K |
| V2750 |
Anti-reflective coating |
2,072 |
1,990 |
$37K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
1,673 |
1,604 |
$30K |
| V2744 |
Tint photochromatic lens/es |
547 |
523 |
$13K |
| V2100 |
Lens spher single plano 4.00 |
243 |
235 |
$3K |
| V2784 |
Lens polycarb or equal |
157 |
154 |
$2K |
| V2799 |
Misc vision item or service |
300 |
169 |
$917.90 |
| V2104 |
Spherocylindr 4.00d/2.12-4d |
45 |
44 |
$570.49 |