NPI: 1548236615 · WICHITA FALLS, TX 76309 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 42 | $0.00 |
| 2023 | 1,781 | $60K |
| 2024 | 1,567 | $52K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 179 | 173 | $18K | |
| 92250 | 273 | 268 | $17K | |
| V2784 | Lens polycarb or equal | 827 | 797 | $15K |
| S0621 | Routine ophthalmological exa | 155 | 154 | $12K |
| V2025 | Eyeglasses delux frames | 290 | 290 | $12K |
| V2020 | Vision svcs frames purchases | 617 | 590 | $11K |
| S0620 | Routine ophthalmological exa | 131 | 131 | $10K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 493 | 473 | $9K |
| 92015 | 351 | 345 | $5K | |
| 92004 | 13 | 13 | $2K | |
| V2100 | Lens spher single plano 4.00 | 61 | 59 | $792.04 |