NPI: 1174691513 · PARMA, OH 44129 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 13 | $650.00 |
| 2021 | 12 | $0.00 |
| 2022 | 204 | $4K |
| 2023 | 27 | $770.52 |
| 2024 | 269 | $5K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 103 | 103 | $4K | |
| V2020 | Vision svcs frames purchases | 164 | 147 | $2K |
| V2784 | Lens polycarb or equal | 66 | 50 | $1K |
| 92014 | 26 | 26 | $1K | |
| V2100 | Lens spher single plano 4.00 | 38 | 38 | $945.44 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 52 | 44 | $750.00 |
| V2744 | Tint photochromatic lens/es | 13 | 13 | $0.00 |
| 92015 | 63 | 63 | $0.00 |