NPI: 1508822271 · FAIRFAX, VA 22030 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 40 | $2K |
| 2019 | 441 | $8K |
| 2020 | 1,310 | $23K |
| 2021 | 457 | $8K |
| 2023 | 16 | $947.30 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 528 | 527 | $21K | |
| V2100 | Lens spher single plano 4.00 | 353 | 349 | $9K |
| V2020 | Vision svcs frames purchases | 324 | 320 | $6K |
| V2784 | Lens polycarb or equal | 344 | 340 | $2K |
| 99213 | 16 | 13 | $947.30 | |
| S0621 | Routine ophthalmological exa | 14 | 14 | $635.00 |
| S0620 | Routine ophthalmological exa | 14 | 14 | $635.00 |
| 92014 | 12 | 12 | $480.00 | |
| 92015 | 659 | 658 | $0.00 |