NPI: 1134334220 · PAGOSA SPRINGS, CO 81147 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 2,302 | $85K |
| 2022 | 2,787 | $102K |
| 2023 | 1,805 | $76K |
| 2024 | 22 | $27.74 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 925 | 881 | $88K | |
| 92004 | 424 | 405 | $49K | |
| V2020 | Vision svcs frames purchases | 762 | 675 | $28K |
| V2781 | Progressive lens per lens | 368 | 346 | $22K |
| V2750 | Anti-reflective coating | 751 | 661 | $18K |
| V2784 | Lens polycarb or equal | 759 | 669 | $16K |
| V2410 | Lens variab asphericity sing | 220 | 181 | $16K |
| 92340 | 743 | 665 | $12K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 264 | 241 | $11K |
| V2744 | Tint photochromatic lens/es | 229 | 189 | $3K |
| V2100 | Lens spher single plano 4.00 | 12 | 12 | $462.27 |
| 92015 | 1,459 | 1,378 | $333.83 |