NPI: 1073985404 · SAINT PETERS, MO 63376 · 332B00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 3,623 | $84K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 1,867 | 1,862 | $30K |
| 92002 | 415 | 415 | $19K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 991 | 984 | $17K |
| 92004 | 174 | 174 | $8K | |
| V2744 | Tint photochromatic lens/es | 72 | 70 | $6K |
| 92012 | 52 | 52 | $2K | |
| 92014 | 25 | 25 | $1K | |
| V2784 | Lens polycarb or equal | 27 | 25 | $324.00 |