NPI: 1073616603 · LAIE, HI 96762 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 334 | $3K |
| 2019 | 651 | $17K |
| 2020 | 463 | $11K |
| 2021 | 365 | $9K |
| 2022 | 113 | $576.82 |
| 2023 | 167 | $872.18 |
| 2024 | 127 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 361 | 341 | $21K |
| 92340 | 366 | 343 | $9K | |
| 92015 | 640 | 615 | $6K | |
| 92004 | 34 | 34 | $2K | |
| V2100 | Lens spher single plano 4.00 | 109 | 103 | $2K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 20 | 18 | $1K |
| 92014 | 29 | 29 | $942.54 | |
| V2756 | Eye glass case | 617 | 591 | $854.22 |
| V2025 | Eyeglasses delux frames | 44 | 44 | $0.00 |