NPI: 1679129233 · BEAUMONT, TX 77706 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 884 | $12K |
| 2021 | 136 | $2K |
| 2022 | 42 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 227 | 181 | $6K | |
| 92004 | 180 | 143 | $6K | |
| V2020 | Vision svcs frames purchases | 94 | 82 | $651.40 |
| 99211 | 14 | 14 | $172.98 | |
| S0620 | Routine ophthalmological exa | 64 | 64 | $0.00 |
| V2100 | Lens spher single plano 4.00 | 16 | 14 | $0.00 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 31 | 29 | $0.00 |
| V2784 | Lens polycarb or equal | 13 | 13 | $0.00 |
| 92015 | 359 | 314 | $0.00 | |
| 92340 | 49 | 38 | $0.00 | |
| 99072 | 15 | 15 | $0.00 |