NPI: 1982631792 · PORT ORANGE, FL 32129 · 152WC0802X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 656 | $643.08 |
| 2022 | 297 | $8K |
| 2023 | 447 | $13K |
| 2024 | 181 | $5K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 305 | 290 | $18K |
| 92014 | 188 | 179 | $7K | |
| 92340 | 295 | 280 | $564.36 | |
| 92004 | 16 | 14 | $530.04 | |
| 92015 | 348 | 325 | $458.47 | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 68 | 62 | $85.26 |
| G0117 | Glaucoma scrn hgh risk direc | 72 | 72 | $0.00 |
| 2022F | 72 | 72 | $0.00 | |
| 3072F | 69 | 69 | $0.00 | |
| 92342 | 74 | 74 | $0.00 | |
| V2756 | Eye glass case | 74 | 74 | $0.00 |