NPI: 1053303289 · PONCE, PR 00717 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 3,405 | $108K |
| 2019 | 4,418 | $97K |
| 2020 | 3,703 | $105K |
| 2021 | 647 | $15K |
| 2022 | 154 | $3K |
| 2023 | 1,041 | $38K |
| 2024 | 3,797 | $162K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92060 | 2,331 | 1,877 | $94K | |
| 92004 | 1,560 | 1,417 | $83K | |
| 92015 | 3,285 | 2,707 | $67K | |
| V2020 | Vision svcs frames purchases | 891 | 810 | $63K |
| 92002 | 714 | 479 | $49K | |
| 92250 | 1,535 | 1,226 | $42K | |
| 92283 | 1,851 | 1,687 | $39K | |
| 92012 | 393 | 259 | $29K | |
| 92083 | 990 | 897 | $20K | |
| 92081 | 758 | 477 | $20K | |
| 92020 | 850 | 738 | $14K | |
| 92225 | 536 | 471 | $6K | |
| V2784 | Lens polycarb or equal | 646 | 301 | $2K |
| 92014 | 14 | 14 | $490.00 | |
| V2100 | Lens spher single plano 4.00 | 762 | 357 | $244.72 |
| 92201 | 49 | 49 | $0.00 |