NPI: 1073090650 · GALLUP, NM 87301 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 464 | $17K |
| 2020 | 3,103 | $99K |
| 2021 | 8,665 | $267K |
| 2022 | 9,393 | $351K |
| 2023 | 9,755 | $492K |
| 2024 | 8,070 | $529K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 6,623 | 6,477 | $763K | |
| 92014 | 3,236 | 3,211 | $361K | |
| V2020 | Vision svcs frames purchases | 6,835 | 6,739 | $252K |
| 92340 | 3,808 | 3,734 | $110K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 2,670 | 2,628 | $77K |
| V2104 | Spherocylindr 4.00d/2.12-4d | 1,302 | 1,293 | $48K |
| 92015 | 7,562 | 7,387 | $42K | |
| V2784 | Lens polycarb or equal | 3,621 | 3,568 | $35K |
| V2100 | Lens spher single plano 4.00 | 753 | 753 | $24K |
| S0580 | Polycarb lens | 2,474 | 2,472 | $21K |
| V2105 | Spherocylinder 4.00d/4.25-6d | 292 | 291 | $10K |
| 99212 | 102 | 93 | $5K | |
| V2200 | Lens spher bifoc plano 4.00d | 61 | 61 | $2K |
| 92341 | 58 | 58 | $2K | |
| 92012 | 28 | 28 | $2K | |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 13 | 13 | $409.56 |
| V2799 | Misc vision item or service | 12 | 12 | $0.00 |