NPI: 1932735412 · HURRICANE, WV 25526 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 69 | $2K |
| 2022 | 2,245 | $28K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 396 | 386 | $9K | |
| V2100 | Lens spher single plano 4.00 | 460 | 457 | $8K |
| V2020 | Vision svcs frames purchases | 507 | 498 | $6K |
| 92004 | 260 | 245 | $5K | |
| V2784 | Lens polycarb or equal | 396 | 389 | $2K |
| V2781 | Progressive lens per lens | 12 | 12 | $220.00 |
| V2299 | Lens bifocal speciality | 12 | 12 | $150.80 |
| 92015 | 180 | 172 | $0.00 | |
| V2750 | Anti-reflective coating | 91 | 85 | $0.00 |