NPI: 1043524283 · ANTIOCH, TN 37013 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,802 | $41K |
| 2019 | 1,574 | $33K |
| 2020 | 452 | $8K |
| 2021 | 133 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 376 | 366 | $22K | |
| 92015 | 401 | 391 | $16K | |
| V2100 | Lens spher single plano 4.00 | 880 | 853 | $14K |
| V2020 | Vision svcs frames purchases | 998 | 966 | $13K |
| 92340 | 295 | 293 | $9K | |
| V2784 | Lens polycarb or equal | 949 | 919 | $7K |
| 92004 | 27 | 27 | $2K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 23 | 21 | $440.00 |
| 3072F | 12 | 12 | $0.00 |