NPI: 1134200967 · DAVENPORT, IA 52806 · 156FX1800X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,550 | $34K |
| 2019 | 1,472 | $34K |
| 2020 | 753 | $17K |
| 2021 | 149 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 2,173 | 2,144 | $50K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 1,146 | 1,128 | $23K |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 179 | 179 | $7K |
| V2100 | Lens spher single plano 4.00 | 348 | 342 | $6K |
| V2781 | Progressive lens per lens | 64 | 64 | $2K |
| V2104 | Spherocylindr 4.00d/2.12-4d | 14 | 14 | $294.02 |