NPI: 1679349419 · JBSA LACKLAND, TX 78236 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 1,150 | $38K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 165 | 161 | $14K | |
| V2782 | Lens, 1.54-1.65 p/1.60-1.79g | 119 | 113 | $6K |
| 92004 | 49 | 49 | $4K | |
| 92015 | 231 | 228 | $4K | |
| 92250 | 111 | 110 | $4K | |
| V2020 | Vision svcs frames purchases | 170 | 166 | $3K |
| 92340 | 167 | 163 | $2K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 112 | 107 | $1K |
| V2100 | Lens spher single plano 4.00 | 26 | 24 | $231.42 |