NPI: 1801515879 · TEXARKANA, TX 75503 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 678 | $14K |
| 2024 | 1,615 | $33K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2103 | Spherocylindr 4.00d/12-2.00d | 641 | 561 | $14K |
| V2020 | Vision svcs frames purchases | 647 | 563 | $11K |
| S0621 | Routine ophthalmological exa | 216 | 207 | $10K |
| S0620 | Routine ophthalmological exa | 132 | 124 | $6K |
| 92004 | 45 | 32 | $2K | |
| 92015 | 240 | 211 | $2K | |
| V2784 | Lens polycarb or equal | 296 | 257 | $1K |
| 92014 | 17 | 12 | $785.84 | |
| 92340 | 13 | 13 | $614.64 | |
| V2100 | Lens spher single plano 4.00 | 46 | 37 | $522.26 |