NPI: 1093001091 · DES MOINES, IA 50309 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 3,569 | $102K |
| 2019 | 3,218 | $99K |
| 2020 | 1,109 | $40K |
| 2021 | 1,311 | $55K |
| 2022 | 1,008 | $53K |
| 2023 | 1,719 | $99K |
| 2024 | 1,343 | $73K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 2,228 | 2,179 | $173K | |
| 92014 | 1,852 | 1,809 | $112K | |
| S0621 | Routine ophthalmological exa | 842 | 823 | $77K |
| 92285 | 1,123 | 1,071 | $44K | |
| V2020 | Vision svcs frames purchases | 1,918 | 1,815 | $44K |
| 92250 | 673 | 641 | $34K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 930 | 605 | $14K |
| 92002 | 161 | 159 | $8K | |
| V2100 | Lens spher single plano 4.00 | 254 | 190 | $4K |
| 92012 | 87 | 87 | $4K | |
| 92015 | 1,685 | 1,649 | $4K | |
| V2784 | Lens polycarb or equal | 817 | 770 | $2K |
| 99213 | 27 | 24 | $1K | |
| V2756 | Eye glass case | 680 | 656 | $668.52 |