NPI: 1114419009 · SIOUX CITY, IA 51101 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 353 | $20K |
| 2021 | 1,069 | $55K |
| 2022 | 1,765 | $78K |
| 2023 | 1,784 | $61K |
| 2024 | 2,277 | $56K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 1,367 | 1,304 | $117K | |
| 92014 | 1,286 | 1,178 | $77K | |
| V2020 | Vision svcs frames purchases | 1,764 | 1,613 | $46K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 1,405 | 839 | $16K |
| 92060 | 242 | 186 | $8K | |
| 92012 | 111 | 97 | $5K | |
| V2100 | Lens spher single plano 4.00 | 82 | 61 | $1K |
| V2784 | Lens polycarb or equal | 44 | 40 | $485.12 |
| 92015 | 947 | 797 | $150.50 |