NPI: 1700040268 · VICTORIA, TX 77901 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 1,712 | $63K |
| 2024 | 1,382 | $43K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 354 | 350 | $36K | |
| 92250 | 255 | 254 | $17K | |
| V2020 | Vision svcs frames purchases | 828 | 808 | $14K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 545 | 537 | $10K |
| 92015 | 524 | 520 | $8K | |
| V2784 | Lens polycarb or equal | 244 | 243 | $6K |
| S0621 | Routine ophthalmological exa | 110 | 109 | $5K |
| V2750 | Anti-reflective coating | 112 | 112 | $4K |
| 92004 | 31 | 31 | $4K | |
| S0620 | Routine ophthalmological exa | 34 | 34 | $1K |
| V2104 | Spherocylindr 4.00d/2.12-4d | 40 | 39 | $760.07 |
| V2100 | Lens spher single plano 4.00 | 17 | 17 | $314.45 |