NPI: 1578185187 · MOUNT VERNON, OH 43050 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 12 | $661.92 |
| 2023 | 916 | $13K |
| 2024 | 1,247 | $28K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 377 | 367 | $11K | |
| 92014 | 369 | 354 | $10K | |
| V2020 | Vision svcs frames purchases | 604 | 581 | $8K |
| V2100 | Lens spher single plano 4.00 | 475 | 459 | $7K |
| V2784 | Lens polycarb or equal | 260 | 250 | $2K |
| S0620 | Routine ophthalmological exa | 40 | 40 | $2K |
| S0621 | Routine ophthalmological exa | 24 | 24 | $1K |
| 92015 | 26 | 26 | $361.26 |