NPI: 1760158257 · AUBURN, AL 36830 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 16 | $300.00 |
| 2024 | 476 | $6K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92340 | 57 | 55 | $2K | |
| 92015 | 85 | 85 | $2K | |
| 92004 | 14 | 14 | $1K | |
| S0516 | Safety frames | 42 | 42 | $671.16 |
| V2020 | Vision svcs frames purchases | 145 | 68 | $495.00 |
| S0504 | Singl prscrp lens | 42 | 42 | $400.86 |
| S9999 | Sales tax | 66 | 66 | $104.16 |
| V2100 | Lens spher single plano 4.00 | 20 | 15 | $42.00 |
| V2784 | Lens polycarb or equal | 21 | 12 | $36.00 |