NPI: 1003999574 · UTUADO, PR 00641 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 361 | $6K |
| 2019 | 297 | $3K |
| 2020 | 537 | $6K |
| 2021 | 1,203 | $11K |
| 2022 | 698 | $7K |
| 2023 | 56 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92015 | 784 | 747 | $22K | |
| 92014 | 379 | 360 | $10K | |
| 92004 | 41 | 41 | $787.50 | |
| V2020 | Vision svcs frames purchases | 665 | 629 | $433.40 |
| V2784 | Lens polycarb or equal | 289 | 285 | $0.00 |
| V2744 | Tint photochromatic lens/es | 354 | 348 | $0.00 |
| V2781 | Progressive lens per lens | 126 | 126 | $0.00 |
| V2200 | Lens spher bifoc plano 4.00d | 41 | 41 | $0.00 |
| V2760 | Scratch resistant coating | 445 | 434 | $0.00 |
| V2750 | Anti-reflective coating | 28 | 28 | $0.00 |