NPI: 1568660181 · SPARTA, TN 38583 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 2,396 | $57K |
| 2019 | 4,118 | $88K |
| 2020 | 3,269 | $73K |
| 2021 | 934 | $9K |
| 2022 | 851 | $9K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 1,994 | 1,903 | $84K | |
| 92004 | 765 | 721 | $41K | |
| 92015 | 2,799 | 2,661 | $33K | |
| 92340 | 1,354 | 1,326 | $26K | |
| V2784 | Lens polycarb or equal | 1,606 | 1,161 | $24K |
| V2020 | Vision svcs frames purchases | 1,440 | 1,372 | $11K |
| V2100 | Lens spher single plano 4.00 | 730 | 452 | $9K |
| 99212 | 475 | 403 | $6K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 355 | 307 | $861.23 |
| 99213 | 50 | 45 | $682.92 |