NPI: 1093907818 · BOSSIER CITY, LA 71111 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 287 | $8K |
| 2024 | 460 | $16K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| S0620 | Routine ophthalmological exa | 139 | 139 | $7K |
| V2020 | Vision svcs frames purchases | 261 | 260 | $6K |
| S0621 | Routine ophthalmological exa | 120 | 119 | $6K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 119 | 118 | $2K |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 41 | 41 | $2K |
| V2025 | Eyeglasses delux frames | 32 | 32 | $1K |
| V2100 | Lens spher single plano 4.00 | 18 | 18 | $280.00 |
| V2104 | Spherocylindr 4.00d/2.12-4d | 17 | 17 | $260.00 |