NPI: 1649239906 · SAN ANTONIO, TX 78221 · Eyewear Supplier · NPI assigned 03/23/2006
| Authorized Official | PAYNE, DEBRA (ADMINISTRATOR) |
| NPI Enumeration Date | 03/23/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 1,081 | $14K |
| 2024 | 730 | $9K |
| Code | Description | Claims | Bene. Records | Total Paid |
|---|---|---|---|---|
| V2020 | Frames, purchases | 826 | 820 | $13K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 686 | 402 | $7K |
| V2104 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens | 282 | 186 | $3K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 17 | 12 | $176.46 |