NPI: 1417935412 · JACKSON, MI 49203 · 332H00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 962 | $30K |
| 2019 | 1,360 | $43K |
| 2020 | 222 | $7K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 469 | 469 | $36K | |
| V2020 | Vision svcs frames purchases | 672 | 669 | $22K |
| 92340 | 388 | 386 | $8K | |
| 92015 | 606 | 604 | $7K | |
| 92341 | 91 | 91 | $2K | |
| V2100 | Lens spher single plano 4.00 | 171 | 170 | $2K |
| 92014 | 24 | 24 | $1K | |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 74 | 74 | $1K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 49 | 49 | $638.82 |