NPI: 1861062176 · HAINES CITY, FL 33844 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 1,129 | $20K |
| 2024 | 1,010 | $23K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 288 | 283 | $18K | |
| V2020 | Vision svcs frames purchases | 410 | 382 | $12K |
| 92004 | 86 | 86 | $5K | |
| 92015 | 526 | 521 | $2K | |
| 92340 | 391 | 365 | $2K | |
| V2782 | Lens, 1.54-1.65 p/1.60-1.79g | 28 | 28 | $1K |
| V2100 | Lens spher single plano 4.00 | 346 | 320 | $1K |
| 92250 | 29 | 29 | $910.76 | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 23 | 23 | $243.60 |
| V2784 | Lens polycarb or equal | 12 | 12 | $0.00 |