NPI: 1518051200 · ARLINGTON, TX 76015 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 141 | $3K |
| 2021 | 1,671 | $37K |
| 2022 | 1,696 | $41K |
| 2023 | 1,611 | $41K |
| 2024 | 686 | $19K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| S0621 | Routine ophthalmological exa | 1,025 | 1,015 | $43K |
| V2020 | Vision svcs frames purchases | 1,501 | 1,459 | $38K |
| V2100 | Lens spher single plano 4.00 | 1,448 | 1,384 | $33K |
| S0620 | Routine ophthalmological exa | 655 | 649 | $27K |
| V2784 | Lens polycarb or equal | 245 | 245 | $854.50 |
| S0580 | Polycarb lens | 919 | 890 | $699.00 |
| V2750 | Anti-reflective coating | 12 | 12 | $0.00 |