NPI: 1154751782 · BRANDON, FL 33511 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 2,083 | $33K |
| 2020 | 520 | $8K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 317 | 310 | $23K | |
| 92004 | 249 | 243 | $13K | |
| 92340 | 482 | 451 | $4K | |
| V2020 | Vision svcs frames purchases | 532 | 508 | $438.50 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 382 | 313 | $22.00 |
| 92015 | 497 | 480 | $0.00 | |
| 92342 | 25 | 25 | $0.00 | |
| V2100 | Lens spher single plano 4.00 | 82 | 57 | $0.00 |
| V2756 | Eye glass case | 25 | 25 | $0.00 |
| V2784 | Lens polycarb or equal | 12 | 12 | $0.00 |