NPI: 1174756142 · IRVING, TX 75060 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 1,276 | $48K |
| 2021 | 4,971 | $177K |
| 2022 | 3,065 | $91K |
| 2023 | 2,696 | $100K |
| 2024 | 1,696 | $57K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 5,040 | 5,003 | $123K |
| S0621 | Routine ophthalmological exa | 2,000 | 1,989 | $103K |
| 92014 | 934 | 932 | $82K | |
| V2100 | Lens spher single plano 4.00 | 3,452 | 3,438 | $65K |
| 92004 | 397 | 396 | $41K | |
| S0620 | Routine ophthalmological exa | 788 | 784 | $38K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 969 | 962 | $18K |
| V2104 | Spherocylindr 4.00d/2.12-4d | 51 | 51 | $1K |
| 92012 | 12 | 12 | $735.72 | |
| V2102 | Singl visn sphere 7.12-20.00 | 29 | 29 | $572.00 |
| V2105 | Spherocylinder 4.00d/4.25-6d | 20 | 19 | $440.00 |
| V2784 | Lens polycarb or equal | 12 | 12 | $200.00 |