NPI: 1669070041 · TOMPKINSVILLE, KY 42167 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 14 | $560.00 |
| 2023 | 25 | $1K |
| 2024 | 428 | $11K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 104 | 104 | $7K | |
| 92004 | 20 | 20 | $2K | |
| 92012 | 39 | 38 | $2K | |
| 92340 | 18 | 18 | $594.00 | |
| S0504 | Singl prscrp lens | 33 | 33 | $311.94 |
| S0516 | Safety frames | 19 | 19 | $303.62 |
| V2020 | Vision svcs frames purchases | 38 | 19 | $142.50 |
| S9999 | Sales tax | 33 | 33 | $56.04 |
| V2784 | Lens polycarb or equal | 34 | 17 | $51.00 |
| 92015 | 129 | 129 | $40.44 |