NPI: 1144210592 · ARLINGTON, TX 76017 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 1,364 | $33K |
| 2021 | 4,102 | $119K |
| 2022 | 8,358 | $260K |
| 2023 | 5,634 | $186K |
| 2024 | 2,640 | $87K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 1,761 | 1,736 | $157K | |
| V2020 | Vision svcs frames purchases | 6,946 | 6,708 | $146K |
| 92004 | 947 | 936 | $99K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 4,146 | 4,014 | $91K |
| 92015 | 3,595 | 3,551 | $49K | |
| 92012 | 589 | 584 | $36K | |
| V2104 | Spherocylindr 4.00d/2.12-4d | 1,161 | 1,126 | $24K |
| V2750 | Anti-reflective coating | 520 | 507 | $18K |
| V2100 | Lens spher single plano 4.00 | 836 | 817 | $16K |
| 92025 | 434 | 431 | $12K | |
| 92250 | 205 | 202 | $10K | |
| 99213 | 306 | 298 | $9K | |
| S0621 | Routine ophthalmological exa | 145 | 140 | $8K |
| V2107 | Spherocylinder 4.25d/12-2d | 226 | 221 | $4K |
| 92310 | 40 | 40 | $3K | |
| 92002 | 25 | 25 | $1K | |
| V2105 | Spherocylinder 4.00d/4.25-6d | 37 | 37 | $758.40 |
| V2784 | Lens polycarb or equal | 115 | 112 | $719.10 |
| 92285 | 52 | 51 | $608.94 | |
| 92286 | 12 | 12 | $314.70 |