NPI: 1861438624 · ORANGE CITY, FL 32763 · 152WC0802X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 4,824 | $4K |
| 2020 | 2,707 | $548.90 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 519 | 519 | $3K | |
| 92004 | 359 | 358 | $2K | |
| V2020 | Vision svcs frames purchases | 881 | 847 | $251.38 |
| 92015 | 838 | 836 | $191.54 | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 804 | 401 | $27.18 |
| 92340 | 771 | 738 | $0.00 | |
| 92341 | 54 | 53 | $0.00 | |
| G0117 | Glaucoma scrn hgh risk direc | 820 | 820 | $0.00 |
| 2022F | 340 | 338 | $0.00 | |
| V2100 | Lens spher single plano 4.00 | 279 | 133 | $0.00 |
| 92342 | 859 | 828 | $0.00 | |
| 3072F | 148 | 148 | $0.00 | |
| V2756 | Eye glass case | 859 | 828 | $0.00 |