NPI: 1386744332 · SAN ANTONIO, TX 78228 · 152WC0802X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 44 | $691.36 |
| 2019 | 94 | $4K |
| 2020 | 757 | $34K |
| 2021 | 2,081 | $84K |
| 2022 | 1,946 | $30K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 664 | 656 | $50K | |
| 92004 | 326 | 320 | $37K | |
| S0621 | Routine ophthalmological exa | 407 | 405 | $17K |
| 92015 | 1,755 | 1,680 | $15K | |
| S0620 | Routine ophthalmological exa | 220 | 219 | $9K |
| V2020 | Vision svcs frames purchases | 460 | 458 | $9K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 451 | 450 | $7K |
| V2784 | Lens polycarb or equal | 165 | 164 | $3K |
| V2025 | Eyeglasses delux frames | 78 | 78 | $3K |
| V2104 | Spherocylindr 4.00d/2.12-4d | 58 | 58 | $873.95 |
| V2100 | Lens spher single plano 4.00 | 28 | 28 | $345.86 |
| V2799 | Misc vision item or service | 17 | 16 | $182.72 |
| V2750 | Anti-reflective coating | 12 | 12 | $140.58 |
| 99072 | 141 | 138 | $0.00 | |
| S9986 | Not medically necessary svc | 140 | 109 | $0.00 |