NPI: 1164491544 · PASADENA, TX 77502 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 388 | $11K |
| 2021 | 658 | $14K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| S0620 | Routine ophthalmological exa | 260 | 250 | $10K |
| V2020 | Vision svcs frames purchases | 331 | 313 | $5K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 252 | 241 | $4K |
| S0621 | Routine ophthalmological exa | 84 | 74 | $3K |
| V2025 | Eyeglasses delux frames | 30 | 30 | $897.26 |
| V2784 | Lens polycarb or equal | 49 | 46 | $480.00 |
| V2100 | Lens spher single plano 4.00 | 25 | 24 | $470.00 |
| V2750 | Anti-reflective coating | 15 | 14 | $0.00 |