NPI: 1275689804 · PLANO, TX 75074 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 15 | $0.00 |
| 2020 | 16 | $0.00 |
| 2021 | 45 | $0.00 |
| 2022 | 847 | $28K |
| 2023 | 575 | $22K |
| 2024 | 424 | $16K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| S0621 | Routine ophthalmological exa | 739 | 724 | $36K |
| V2025 | Eyeglasses delux frames | 239 | 234 | $11K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 508 | 499 | $10K |
| V2020 | Vision svcs frames purchases | 305 | 299 | $7K |
| S0620 | Routine ophthalmological exa | 29 | 28 | $1K |
| V2784 | Lens polycarb or equal | 26 | 26 | $338.00 |
| 1036F | 76 | 54 | $0.00 |