NPI: 1487146635 · SAINT AUGUSTINE, FL 32092 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 543 | $4K |
| 2020 | 289 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 67 | 67 | $4K | |
| 92004 | 29 | 29 | $1K | |
| V2020 | Vision svcs frames purchases | 181 | 180 | $863.11 |
| 92015 | 271 | 270 | $593.49 | |
| 92340 | 173 | 173 | $65.00 | |
| G0117 | Glaucoma scrn hgh risk direc | 28 | 28 | $0.00 |
| 2022F | 14 | 14 | $0.00 | |
| 92342 | 28 | 28 | $0.00 | |
| V2100 | Lens spher single plano 4.00 | 28 | 26 | $0.00 |
| V2756 | Eye glass case | 13 | 13 | $0.00 |