NPI: 1154466019 · EDEN PRAIRIE, MN 55344 · 156FC0800X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 435 | $2K |
| 2019 | 827 | $21K |
| 2020 | 1,394 | $33K |
| 2021 | 2,055 | $44K |
| 2022 | 348 | $5K |
| 2023 | 149 | $2K |
| 2024 | 14 | $682.20 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 1,358 | 1,201 | $28K |
| V2784 | Lens polycarb or equal | 1,361 | 1,193 | $21K |
| 92340 | 964 | 830 | $17K | |
| 92004 | 175 | 172 | $17K | |
| 92015 | 755 | 738 | $8K | |
| 92250 | 231 | 226 | $6K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 225 | 180 | $4K |
| V2100 | Lens spher single plano 4.00 | 57 | 54 | $4K |
| 92014 | 43 | 40 | $3K | |
| V2025 | Eyeglasses delux frames | 53 | 52 | $0.00 |