NPI: 1144628074 · FARMINGTON, NM 87402 · 332H00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 161 | $1K |
| 2020 | 674 | $5K |
| 2021 | 1,375 | $12K |
| 2022 | 1,309 | $14K |
| 2023 | 1,134 | $26K |
| 2024 | 897 | $27K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 2,667 | 2,405 | $59K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 1,049 | 938 | $18K |
| V2104 | Spherocylindr 4.00d/2.12-4d | 303 | 268 | $6K |
| V2784 | Lens polycarb or equal | 1,092 | 966 | $1K |
| V2100 | Lens spher single plano 4.00 | 38 | 38 | $970.68 |
| V2105 | Spherocylinder 4.00d/4.25-6d | 27 | 24 | $965.47 |
| V2799 | Misc vision item or service | 47 | 47 | $63.18 |
| V2744 | Tint photochromatic lens/es | 50 | 48 | $0.00 |
| V2781 | Progressive lens per lens | 26 | 24 | $0.00 |
| 92340 | 251 | 251 | $0.00 |