NPI: 1316968233 · ORANGE PARK, FL 32073 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 1,912 | $16K |
| 2020 | 187 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 159 | 147 | $12K | |
| 92340 | 294 | 258 | $3K | |
| 92004 | 77 | 75 | $2K | |
| 92342 | 212 | 210 | $821.78 | |
| 92341 | 41 | 41 | $221.80 | |
| V2020 | Vision svcs frames purchases | 372 | 347 | $109.48 |
| V2100 | Lens spher single plano 4.00 | 194 | 143 | $0.00 |
| V2756 | Eye glass case | 154 | 154 | $0.00 |
| V2784 | Lens polycarb or equal | 136 | 133 | $0.00 |
| 3072F | 16 | 16 | $0.00 | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 32 | 16 | $0.00 |
| 2022F | 63 | 62 | $0.00 | |
| 92015 | 333 | 299 | $0.00 | |
| V2750 | Anti-reflective coating | 16 | 16 | $0.00 |