NPI: 1891738845 · ORANGE CITY, FL 32763 · 152WC0802X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 2,082 | $5K |
| 2020 | 1,024 | $12K |
| 2021 | 935 | $11K |
| 2022 | 4,162 | $107K |
| 2023 | 1,138 | $34K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 1,727 | 1,567 | $91K |
| 92014 | 1,022 | 931 | $45K | |
| 92004 | 714 | 677 | $33K | |
| V2100 | Lens spher single plano 4.00 | 744 | 594 | $427.70 |
| 92015 | 1,962 | 1,819 | $336.54 | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 611 | 498 | $325.07 |
| 92340 | 1,523 | 1,378 | $75.00 | |
| 92341 | 17 | 12 | $15.00 | |
| V2784 | Lens polycarb or equal | 40 | 38 | $5.00 |
| G0117 | Glaucoma scrn hgh risk direc | 234 | 234 | $0.00 |
| 2022F | 193 | 193 | $0.00 | |
| 92342 | 181 | 181 | $0.00 | |
| 3072F | 192 | 192 | $0.00 | |
| V2756 | Eye glass case | 181 | 181 | $0.00 |