NPI: 1932784436 · JACKSON, MI 49202 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 323 | $7K |
| 2022 | 541 | $13K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 291 | 284 | $8K |
| 92004 | 78 | 78 | $5K | |
| 92015 | 209 | 209 | $2K | |
| 92340 | 90 | 89 | $2K | |
| V2100 | Lens spher single plano 4.00 | 84 | 84 | $1K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 87 | 87 | $768.45 |
| 92014 | 13 | 13 | $764.68 | |
| S0620 | Routine ophthalmological exa | 12 | 12 | $447.50 |