NPI: 1932174406 · FORT WORTH, TX 76133 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 77 | $3K |
| 2019 | 41 | $657.34 |
| 2020 | 481 | $21K |
| 2021 | 2,413 | $107K |
| 2022 | 2,078 | $104K |
| 2023 | 2,349 | $124K |
| 2024 | 1,322 | $66K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| S0621 | Routine ophthalmological exa | 2,532 | 2,431 | $132K |
| S0620 | Routine ophthalmological exa | 2,500 | 2,432 | $125K |
| 92014 | 1,750 | 1,748 | $85K | |
| 92004 | 1,662 | 1,659 | $80K | |
| 92015 | 132 | 130 | $2K | |
| V2020 | Vision svcs frames purchases | 47 | 47 | $1K |
| 99214 | 30 | 30 | $502.70 | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 13 | 13 | $381.00 |
| V2784 | Lens polycarb or equal | 31 | 31 | $143.00 |
| 92025 | 14 | 14 | $0.00 | |
| V2799 | Misc vision item or service | 12 | 12 | $0.00 |
| 3072F | 38 | 38 | $0.00 |