NPI: 1104562552 · SAINT CLOUD, MN 56301 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 1,208 | $49K |
| 2023 | 5,381 | $232K |
| 2024 | 4,383 | $203K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 1,543 | 1,514 | $119K |
| 92014 | 1,060 | 1,026 | $88K | |
| V2020 | Vision svcs frames purchases | 2,062 | 2,019 | $74K |
| V2784 | Lens polycarb or equal | 1,212 | 1,182 | $52K |
| V2200 | Lens spher bifoc plano 4.00d | 473 | 459 | $37K |
| 92004 | 405 | 398 | $36K | |
| 92370 | 1,745 | 1,711 | $34K | |
| 92015 | 1,537 | 1,496 | $19K | |
| 92340 | 684 | 671 | $16K | |
| 92341 | 238 | 236 | $7K | |
| 92342 | 13 | 12 | $391.28 |