NPI: 1669466348 · PLANO, TX 75074 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 776 | $23K |
| 2021 | 3,240 | $100K |
| 2022 | 1,684 | $54K |
| 2023 | 1,444 | $55K |
| 2024 | 593 | $22K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| S0621 | Routine ophthalmological exa | 2,469 | 2,388 | $119K |
| V2020 | Vision svcs frames purchases | 1,982 | 1,932 | $50K |
| S0620 | Routine ophthalmological exa | 969 | 960 | $45K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 1,247 | 1,213 | $29K |
| V2100 | Lens spher single plano 4.00 | 213 | 212 | $5K |
| V2784 | Lens polycarb or equal | 685 | 672 | $4K |
| V2104 | Spherocylindr 4.00d/2.12-4d | 52 | 51 | $1K |
| V2750 | Anti-reflective coating | 120 | 118 | $0.00 |