NPI: 1972073294 · SAN ANTONIO, TX 78237 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 312 | $0.00 |
| 2022 | 1,021 | $0.00 |
| 2023 | 1,301 | $24K |
| 2024 | 834 | $18K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| S0621 | Routine ophthalmological exa | 457 | 456 | $15K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 647 | 628 | $8K |
| V2784 | Lens polycarb or equal | 542 | 528 | $8K |
| V2020 | Vision svcs frames purchases | 621 | 605 | $7K |
| S0620 | Routine ophthalmological exa | 91 | 91 | $3K |
| V2025 | Eyeglasses delux frames | 42 | 37 | $605.78 |
| 92015 | 849 | 840 | $0.00 | |
| V2750 | Anti-reflective coating | 14 | 14 | $0.00 |
| 92014 | 64 | 62 | $0.00 | |
| S9986 | Not medically necessary svc | 53 | 53 | $0.00 |
| V2755 | Uv lens/es | 13 | 13 | $0.00 |
| V2104 | Spherocylindr 4.00d/2.12-4d | 46 | 45 | $0.00 |
| 92004 | 29 | 29 | $0.00 |