NPI: 1376983874 · PENSACOLA, FL 32503 · 152WL0500X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 35 | $977.20 |
| 2022 | 3,182 | $94K |
| 2023 | 2,301 | $64K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 629 | 623 | $58K | |
| 92014 | 580 | 575 | $40K | |
| V2020 | Vision svcs frames purchases | 890 | 772 | $21K |
| 92340 | 656 | 633 | $19K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 695 | 498 | $9K |
| V2784 | Lens polycarb or equal | 669 | 609 | $6K |
| 92015 | 1,248 | 1,235 | $4K | |
| V2100 | Lens spher single plano 4.00 | 113 | 74 | $1K |
| V2750 | Anti-reflective coating | 26 | 25 | $340.22 |
| 92310 | 12 | 12 | $152.29 |