NPI: 1134274590 · WAILUKU, HI 96793 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 530 | $7K |
| 2019 | 623 | $15K |
| 2020 | 214 | $6K |
| 2021 | 326 | $9K |
| 2022 | 86 | $426.60 |
| 2023 | 132 | $583.79 |
| 2024 | 46 | $200.20 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 353 | 345 | $21K |
| 92015 | 733 | 722 | $7K | |
| 92340 | 141 | 140 | $4K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 52 | 52 | $2K |
| 92004 | 14 | 14 | $995.29 | |
| V2784 | Lens polycarb or equal | 27 | 27 | $945.00 |
| V2756 | Eye glass case | 598 | 580 | $861.07 |
| 92014 | 13 | 13 | $604.80 | |
| V2100 | Lens spher single plano 4.00 | 12 | 12 | $71.96 |
| V2025 | Eyeglasses delux frames | 14 | 13 | $0.00 |