NPI: 1831627900 · HAMPTON, VA 23666 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 4,274 | $120K |
| 2022 | 1,674 | $45K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 664 | 657 | $59K | |
| 92014 | 834 | 821 | $59K | |
| V2020 | Vision svcs frames purchases | 1,186 | 1,027 | $18K |
| V2100 | Lens spher single plano 4.00 | 637 | 529 | $10K |
| 92012 | 162 | 162 | $8K | |
| 99211 | 427 | 426 | $5K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 247 | 247 | $4K |
| V2200 | Lens spher bifoc plano 4.00d | 20 | 13 | $599.45 |
| 92015 | 1,771 | 1,621 | $0.00 |