NPI: 1063047355 · ODESSA, FL 33556 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 1,996 | $27K |
| 2023 | 1,196 | $14K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 468 | 300 | $32K |
| 92014 | 227 | 208 | $6K | |
| 92004 | 74 | 70 | $2K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 224 | 132 | $379.70 |
| 3072F | 527 | 403 | $364.36 | |
| 92340 | 492 | 300 | $270.00 | |
| 92015 | 387 | 358 | $75.00 | |
| V2100 | Lens spher single plano 4.00 | 25 | 14 | $27.18 |
| V2760 | Scratch resistant coating | 364 | 236 | $0.00 |
| V2755 | Uv lens/es | 367 | 238 | $0.00 |
| V2784 | Lens polycarb or equal | 37 | 29 | $0.00 |