NPI: 1437188562 · LAKE CITY, FL 32025 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 68 | $1K |
| 2021 | 146 | $4K |
| 2022 | 1,416 | $38K |
| 2023 | 1,357 | $30K |
| 2024 | 2,156 | $68K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 665 | 648 | $79K | |
| 92014 | 284 | 271 | $28K | |
| V2784 | Lens polycarb or equal | 480 | 457 | $15K |
| 92340 | 1,000 | 952 | $5K | |
| 92015 | 931 | 907 | $5K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 772 | 445 | $5K |
| V2020 | Vision svcs frames purchases | 956 | 917 | $5K |
| V2100 | Lens spher single plano 4.00 | 55 | 38 | $288.50 |