NPI: 1831745199 · PHILADELPHIA, MS 39350 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 1,182 | $34K |
| 2021 | 1,256 | $43K |
| 2022 | 969 | $30K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 504 | 460 | $47K | |
| V2020 | Vision svcs frames purchases | 661 | 614 | $22K |
| 92015 | 778 | 697 | $13K | |
| 92340 | 588 | 542 | $10K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 301 | 286 | $8K |
| 92004 | 81 | 64 | $8K | |
| V2784 | Lens polycarb or equal | 345 | 334 | $0.00 |
| 1036F | 99 | 76 | $0.00 | |
| G8427 | Docrev cur meds by elig clin | 36 | 33 | $0.00 |
| G8783 | Bp scrn perf rec interval | 14 | 12 | $0.00 |