NPI: 1467452474 · ST AUGUSTINE, FL 32095 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 406 | $1K |
| 2020 | 281 | $2K |
| 2021 | 771 | $34K |
| 2022 | 2,436 | $109K |
| 2023 | 1,136 | $44K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 454 | 434 | $95K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 669 | 456 | $50K |
| 92014 | 145 | 144 | $30K | |
| V2020 | Vision svcs frames purchases | 1,070 | 772 | $7K |
| V2783 | Lens, >= 1.66 p/>=1.80 g | 641 | 433 | $5K |
| 92340 | 991 | 701 | $2K | |
| 92015 | 873 | 843 | $595.00 | |
| 92342 | 40 | 40 | $43.36 | |
| 3072F | 22 | 22 | $0.00 | |
| V2756 | Eye glass case | 39 | 39 | $0.00 |
| V2784 | Lens polycarb or equal | 22 | 15 | $0.00 |
| 2022F | 64 | 64 | $0.00 |