NPI: 1093874364 · FAIRMONT, MN 56031 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 887 | $253.54 |
| 2019 | 617 | $6K |
| 2020 | 272 | $5K |
| 2021 | 177 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 134 | 129 | $7K | |
| 92015 | 456 | 420 | $4K | |
| V2020 | Vision svcs frames purchases | 127 | 110 | $1K |
| V2100 | Lens spher single plano 4.00 | 68 | 28 | $1K |
| 92340 | 32 | 26 | $306.96 | |
| 1036F | 226 | 208 | $0.00 | |
| G9903 | Pt scrn tbco id as non user | 199 | 182 | $0.00 |
| G9974 | Mac exam perf | 178 | 158 | $0.00 |
| G8427 | Docrev cur meds by elig clin | 425 | 392 | $0.00 |
| G8785 | Bp scrn no perf at interval | 108 | 99 | $0.00 |