NPI: 1437236213 · SAN GERMAN, PR 00683 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 2,942 | $58K |
| 2019 | 2,285 | $50K |
| 2020 | 2,082 | $76K |
| 2021 | 2,145 | $71K |
| 2022 | 2,567 | $97K |
| 2023 | 2,603 | $114K |
| 2024 | 2,516 | $104K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92002 | 4,084 | 3,975 | $156K | |
| 92015 | 6,343 | 6,155 | $129K | |
| V2020 | Vision svcs frames purchases | 1,642 | 1,601 | $109K |
| 92012 | 2,041 | 1,961 | $96K | |
| 92100 | 2,542 | 2,449 | $81K | |
| 92250 | 104 | 104 | $538.75 | |
| V2100 | Lens spher single plano 4.00 | 17 | 14 | $102.36 |
| V2200 | Lens spher bifoc plano 4.00d | 221 | 216 | $0.00 |
| V2784 | Lens polycarb or equal | 119 | 119 | $0.00 |
| 92004 | 27 | 26 | $0.00 |