NPI: 1740278357 · ROYAL OAK, MI 48073 · 332H00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,825 | $50K |
| 2019 | 673 | $15K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92340 | 805 | 796 | $17K | |
| V2020 | Vision svcs frames purchases | 406 | 404 | $13K |
| 92004 | 123 | 123 | $10K | |
| S0620 | Routine ophthalmological exa | 163 | 160 | $7K |
| 92014 | 88 | 88 | $6K | |
| 92015 | 433 | 424 | $5K | |
| V2100 | Lens spher single plano 4.00 | 241 | 240 | $3K |
| 92060 | 60 | 59 | $2K | |
| 92341 | 62 | 60 | $1K | |
| S0621 | Routine ophthalmological exa | 26 | 26 | $1K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 13 | 13 | $270.50 |
| V2756 | Eye glass case | 78 | 78 | $21.06 |