NPI: 1871593764 · CLEWISTON, FL 33440 · 207W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 1,223 | $18K |
| 2021 | 1,841 | $32K |
| 2022 | 1,653 | $31K |
| 2023 | 860 | $14K |
| 2024 | 397 | $7K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 1,320 | 1,189 | $36K |
| 92004 | 512 | 499 | $36K | |
| 92014 | 272 | 268 | $18K | |
| V2784 | Lens polycarb or equal | 610 | 440 | $8K |
| 92015 | 1,264 | 1,221 | $2K | |
| 92340 | 994 | 883 | $997.50 | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 865 | 469 | $36.54 |
| V2100 | Lens spher single plano 4.00 | 125 | 76 | $0.00 |
| S0620 | Routine ophthalmological exa | 12 | 12 | $0.00 |