NPI: 1144285891 · DALLAS, TX 75237 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 114 | $3K |
| 2021 | 569 | $15K |
| 2022 | 251 | $5K |
| 2023 | 429 | $8K |
| 2024 | 186 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 924 | 857 | $15K |
| S0621 | Routine ophthalmological exa | 177 | 170 | $9K |
| V2100 | Lens spher single plano 4.00 | 266 | 234 | $5K |
| V2201 | Lens sphere bifocal 4.12-7.0 | 97 | 96 | $2K |
| V2025 | Eyeglasses delux frames | 31 | 30 | $2K |
| S0620 | Routine ophthalmological exa | 26 | 26 | $1K |
| V2101 | Single visn sphere 4.12-7.00 | 28 | 28 | $491.66 |