NPI: 1174648687 · APPLE VALLEY, CA 92308 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 4,848 | $106K |
| 2019 | 7,158 | $155K |
| 2020 | 9,000 | $190K |
| 2021 | 8,171 | $177K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 5,358 | 5,272 | $201K | |
| V2020 | Vision svcs frames purchases | 6,160 | 6,079 | $126K |
| 92340 | 5,552 | 5,474 | $115K | |
| 92014 | 2,370 | 2,345 | $89K | |
| 92015 | 7,755 | 7,622 | $61K | |
| 92341 | 625 | 620 | $17K | |
| 92250 | 260 | 259 | $11K | |
| V2784 | Lens polycarb or equal | 1,067 | 1,063 | $8K |
| V2100 | Lens spher single plano 4.00 | 30 | 30 | $475.90 |