NPI: 1619461506 · RICHARDSON, TX 75081 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 13 | $0.00 |
| 2023 | 1,495 | $20K |
| 2024 | 1,193 | $16K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| S0621 | Routine ophthalmological exa | 528 | 523 | $26K |
| S0620 | Routine ophthalmological exa | 202 | 201 | $8K |
| V2020 | Vision svcs frames purchases | 643 | 638 | $585.00 |
| V2100 | Lens spher single plano 4.00 | 548 | 543 | $174.16 |
| V2784 | Lens polycarb or equal | 407 | 403 | $88.00 |
| 92015 | 194 | 194 | $0.00 | |
| V2760 | Scratch resistant coating | 50 | 50 | $0.00 |
| 92014 | 41 | 41 | $0.00 | |
| 92004 | 18 | 18 | $0.00 | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 70 | 70 | $0.00 |