NPI: 1780810101 · GUAYAMA, PR 00784 · 332H00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 147 | $4K |
| 2019 | 573 | $14K |
| 2020 | 691 | $9K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92015 | 507 | 505 | $15K | |
| 92002 | 353 | 352 | $11K | |
| V2303 | Lens sphcy trifocal 4.0/.12- | 12 | 12 | $750.78 |
| 92012 | 13 | 12 | $378.00 | |
| V2760 | Scratch resistant coating | 82 | 82 | $0.00 |
| V2020 | Vision svcs frames purchases | 87 | 87 | $0.00 |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 12 | 12 | $0.00 |
| V2750 | Anti-reflective coating | 12 | 12 | $0.00 |
| 92004 | 48 | 48 | $0.00 | |
| V2702 | Deluxe lens feature | 67 | 67 | $0.00 |
| V2755 | Uv lens/es | 85 | 85 | $0.00 |
| V2784 | Lens polycarb or equal | 57 | 57 | $0.00 |
| V2781 | Progressive lens per lens | 32 | 32 | $0.00 |
| V2744 | Tint photochromatic lens/es | 44 | 44 | $0.00 |