NPI: 1699000604
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 858 | $37K |
| 2019 | 516 | $23K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 411 | 405 | $27K |
| V2020 | Frames, purchases | 441 | 433 | $24K |
| 92340 | 316 | 314 | $4K | |
| 92004 | 29 | 29 | $2K | |
| S0580 | Polycarbonate lens (list this code in addition to the basic code for the lens) | 67 | 66 | $1K |
| 92341 | 45 | 45 | $900.00 | |
| 92371 | 45 | 45 | $301.00 | |
| 92015 | 20 | 20 | $0.00 |