NPI: 1689761249 · ARLINGTON, TX 76005 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 39 | $1K |
| 2020 | 345 | $7K |
| 2021 | 2,147 | $55K |
| 2022 | 1,905 | $57K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 1,419 | 1,388 | $34K |
| S0620 | Routine ophthalmological exa | 716 | 708 | $33K |
| V2020 | Vision svcs frames purchases | 1,448 | 1,400 | $27K |
| S0621 | Routine ophthalmological exa | 525 | 522 | $24K |
| V2784 | Lens polycarb or equal | 206 | 205 | $1K |
| 92014 | 35 | 34 | $825.08 | |
| V2750 | Anti-reflective coating | 15 | 15 | $278.60 |
| 92015 | 72 | 72 | $225.58 |