NPI: 1619375680 · VICTORIA, TX 77904 · 332H00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 137 | $2K |
| 2021 | 563 | $6K |
| 2022 | 1,225 | $15K |
| 2023 | 825 | $11K |
| 2024 | 781 | $15K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2103 | Spherocylindr 4.00d/12-2.00d | 705 | 695 | $16K |
| V2025 | Eyeglasses delux frames | 485 | 483 | $12K |
| V2020 | Vision svcs frames purchases | 510 | 499 | $11K |
| V2784 | Lens polycarb or equal | 1,082 | 1,068 | $7K |
| V2750 | Anti-reflective coating | 720 | 714 | $2K |
| V2104 | Spherocylindr 4.00d/2.12-4d | 29 | 27 | $517.82 |