NPI: 1386653988 · SAN ANTONIO, TX 78214 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 16 | $186.72 |
| 2020 | 853 | $21K |
| 2021 | 4,867 | $123K |
| 2022 | 4,424 | $116K |
| 2023 | 4,097 | $147K |
| 2024 | 2,750 | $97K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92250 | 1,849 | 1,801 | $82K | |
| S0621 | Routine ophthalmological exa | 1,739 | 1,672 | $77K |
| 92014 | 924 | 915 | $70K | |
| V2020 | Vision svcs frames purchases | 3,146 | 3,019 | $62K |
| 92081 | 2,046 | 1,994 | $49K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 2,165 | 2,098 | $36K |
| S0620 | Routine ophthalmological exa | 825 | 804 | $36K |
| V2784 | Lens polycarb or equal | 1,853 | 1,779 | $36K |
| 92004 | 253 | 247 | $24K | |
| 92015 | 1,429 | 1,400 | $17K | |
| V2025 | Eyeglasses delux frames | 132 | 131 | $7K |
| V2104 | Spherocylindr 4.00d/2.12-4d | 421 | 413 | $6K |
| V2100 | Lens spher single plano 4.00 | 225 | 215 | $3K |