NPI: 1699716266 · ADA, OK 74820 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 313 | $15K |
| 2019 | 382 | $18K |
| 2020 | 240 | $12K |
| 2021 | 349 | $14K |
| 2022 | 337 | $25K |
| 2023 | 394 | $19K |
| 2024 | 12 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 264 | 264 | $31K | |
| 92014 | 314 | 314 | $27K | |
| 99205 | Prolong outpt/office vis | 98 | 98 | $17K |
| 92340 | 413 | 412 | $12K | |
| 92015 | 416 | 416 | $7K | |
| V2020 | Vision svcs frames purchases | 413 | 412 | $4K |
| 99215 | Prolong outpt/office vis | 27 | 27 | $4K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 69 | 69 | $2K |
| V2100 | Lens spher single plano 4.00 | 13 | 13 | $348.75 |