NPI: 1750013181 · MISSION VIEJO, CA 92691 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 28 | $1K |
| 2023 | 1,352 | $50K |
| 2024 | 713 | $20K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 513 | 505 | $22K | |
| 92004 | 458 | 442 | $20K | |
| V2020 | Vision svcs frames purchases | 476 | 455 | $15K |
| V2100 | Lens spher single plano 4.00 | 257 | 252 | $8K |
| 92015 | 190 | 178 | $3K | |
| 92340 | 88 | 74 | $1K | |
| V2784 | Lens polycarb or equal | 84 | 70 | $469.00 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 27 | 17 | $280.00 |