NPI: 1689160350 · WINTER HAVEN, FL 33881 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 66 | $348.10 |
| 2022 | 4,312 | $42K |
| 2023 | 1,622 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2103 | Spherocylindr 4.00d/12-2.00d | 883 | 518 | $17K |
| 92014 | 958 | 527 | $11K | |
| 92004 | 372 | 206 | $11K | |
| V2100 | Lens spher single plano 4.00 | 160 | 78 | $2K |
| 92015 | 981 | 638 | $1K | |
| V2020 | Vision svcs frames purchases | 881 | 524 | $624.60 |
| 92340 | 1,206 | 709 | $357.96 | |
| V2784 | Lens polycarb or equal | 156 | 65 | $0.00 |
| V2750 | Anti-reflective coating | 34 | 14 | $0.00 |
| V2025 | Eyeglasses delux frames | 369 | 188 | $0.00 |