NPI: 1316901499 · SPRINGFIELD, VA 22152 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 317 | $15K |
| 2019 | 39 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 119 | 119 | $9K |
| S0621 | Routine ophthalmological exa | 84 | 84 | $4K |
| 92014 | 30 | 30 | $1K | |
| V2025 | Eyeglasses delux frames | 55 | 53 | $1K |
| V2760 | Scratch resistant coating | 41 | 41 | $820.00 |
| V2750 | Anti-reflective coating | 12 | 12 | $403.00 |
| V2020 | Vision svcs frames purchases | 15 | 15 | $133.44 |