NPI: 1912499765 · MILFORD, OH 45150 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 2,510 | $47K |
| 2021 | 47 | $673.20 |
| 2022 | 339 | $5K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 539 | 537 | $13K |
| V2020 | Vision svcs frames purchases | 694 | 691 | $12K |
| 92004 | 263 | 263 | $11K | |
| 92014 | 194 | 194 | $8K | |
| V2784 | Lens polycarb or equal | 546 | 543 | $5K |
| S0621 | Routine ophthalmological exa | 38 | 37 | $2K |
| S0620 | Routine ophthalmological exa | 31 | 31 | $1K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 12 | 12 | $240.00 |
| V2750 | Anti-reflective coating | 72 | 71 | $0.00 |
| 92015 | 482 | 481 | $0.00 | |
| V2755 | Uv lens/es | 12 | 12 | $0.00 |
| V2799 | Misc vision item or service | 13 | 13 | $0.00 |