NPI: 1841847142 · FAJARDO, PR 00738 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 45 | $715.00 |
| 2020 | 153 | $3K |
| 2021 | 316 | $5K |
| 2022 | 527 | $8K |
| 2023 | 206 | $6K |
| 2024 | 88 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92002 | 426 | 422 | $14K | |
| 92015 | 410 | 403 | $11K | |
| V2799 | Misc vision item or service | 34 | 31 | $0.00 |
| V2781 | Progressive lens per lens | 100 | 99 | $0.00 |
| V2744 | Tint photochromatic lens/es | 101 | 101 | $0.00 |
| V2020 | Vision svcs frames purchases | 249 | 243 | $0.00 |
| V2750 | Anti-reflective coating | 15 | 15 | $0.00 |