NPI: 1134434673 · GARLAND, TX 75040 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 769 | $31K |
| 2021 | 2,910 | $106K |
| 2022 | 2,744 | $52K |
| 2023 | 563 | $6K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 1,854 | 1,720 | $53K |
| 92004 | 486 | 456 | $45K | |
| 92014 | 602 | 543 | $42K | |
| V2100 | Lens spher single plano 4.00 | 1,778 | 1,624 | $32K |
| 92015 | 1,304 | 1,191 | $12K | |
| S0621 | Routine ophthalmological exa | 156 | 150 | $8K |
| S0620 | Routine ophthalmological exa | 59 | 53 | $3K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 141 | 139 | $230.00 |
| V2784 | Lens polycarb or equal | 360 | 334 | $195.00 |
| V2750 | Anti-reflective coating | 108 | 99 | $0.00 |
| V2760 | Scratch resistant coating | 25 | 24 | $0.00 |
| V2799 | Misc vision item or service | 98 | 87 | $0.00 |
| V2104 | Spherocylindr 4.00d/2.12-4d | 15 | 15 | $0.00 |