NPI: 1902107279 · DONNA, TX 78537 · 152WX0102X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 31 | $511.70 |
| 2020 | 549 | $18K |
| 2021 | 3,817 | $149K |
| 2022 | 4,187 | $168K |
| 2023 | 2,809 | $96K |
| 2024 | 2,973 | $126K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| S0621 | Routine ophthalmological exa | 2,480 | 2,478 | $150K |
| V2100 | Lens spher single plano 4.00 | 4,185 | 4,076 | $130K |
| V2020 | Vision svcs frames purchases | 4,319 | 4,210 | $101K |
| 92014 | 815 | 814 | $82K | |
| 92004 | 559 | 557 | $68K | |
| 92250 | 148 | 147 | $9K | |
| 92012 | 114 | 101 | $8K | |
| S0620 | Routine ophthalmological exa | 84 | 84 | $5K |
| 92060 | 70 | 70 | $4K | |
| 92015 | 1,575 | 1,572 | $900.76 | |
| 3072F | 17 | 12 | $90.00 |