NPI: 1750972634 · PORT SAINT LUCIE, FL 34952 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 1,683 | $15K |
| 2023 | 180 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2103 | Spherocylindr 4.00d/12-2.00d | 199 | 117 | $9K |
| 92004 | 199 | 146 | $4K | |
| 92014 | 159 | 104 | $3K | |
| V2020 | Vision svcs frames purchases | 159 | 96 | $2K |
| 92340 | 271 | 171 | $140.00 | |
| V2100 | Lens spher single plano 4.00 | 15 | 15 | $87.18 |
| V2025 | Eyeglasses delux frames | 58 | 43 | $0.00 |
| 92015 | 404 | 297 | $0.00 | |
| V2760 | Scratch resistant coating | 233 | 143 | $0.00 |
| V2784 | Lens polycarb or equal | 166 | 101 | $0.00 |