NPI: 1134432149 · FARMINGTON, MO 63640 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 2,235 | $33K |
| 2019 | 1,138 | $17K |
| 2020 | 104 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 878 | 747 | $15K |
| 92004 | 295 | 254 | $12K | |
| 92014 | 274 | 246 | $12K | |
| V2784 | Lens polycarb or equal | 703 | 635 | $7K |
| 92015 | 704 | 631 | $3K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 526 | 435 | $2K |
| V2100 | Lens spher single plano 4.00 | 49 | 39 | $237.51 |
| S0580 | Polycarb lens | 48 | 17 | $0.00 |