NPI: 1912954983 · JACKSON, TN 38305 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 1,157 | $14K |
| 2020 | 2,472 | $53K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 430 | 373 | $18K | |
| 92015 | 578 | 484 | $14K | |
| V2784 | Lens polycarb or equal | 663 | 513 | $11K |
| 92340 | 489 | 374 | $10K | |
| 92004 | 105 | 100 | $6K | |
| V2020 | Vision svcs frames purchases | 611 | 497 | $4K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 169 | 163 | $2K |
| V2100 | Lens spher single plano 4.00 | 306 | 251 | $2K |
| 92250 | 80 | 72 | $481.03 | |
| S9986 | Not medically necessary svc | 198 | 191 | $384.00 |