NPI: 1699956136 · STERLING, VA 20166 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 12 | $667.00 |
| 2024 | 473 | $18K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 228 | 214 | $13K | |
| V2020 | Vision svcs frames purchases | 55 | 53 | $3K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 15 | 13 | $847.50 |
| V2100 | Lens spher single plano 4.00 | 17 | 16 | $529.54 |
| 92015 | 128 | 125 | $421.74 | |
| V2025 | Eyeglasses delux frames | 16 | 15 | $375.00 |
| V2784 | Lens polycarb or equal | 26 | 26 | $344.90 |