NPI: 1164589446 · CARUTHERSVILLE, MO 63830 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 881 | $11K |
| 2019 | 1,177 | $19K |
| 2020 | 666 | $11K |
| 2021 | 348 | $5K |
| 2022 | 229 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 1,006 | 959 | $18K |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 321 | 169 | $9K |
| 92014 | 163 | 143 | $7K | |
| 92015 | 1,196 | 1,135 | $5K | |
| V2784 | Lens polycarb or equal | 380 | 172 | $5K |
| 92004 | 31 | 30 | $1K | |
| V2100 | Lens spher single plano 4.00 | 126 | 51 | $1K |
| V2200 | Lens spher bifoc plano 4.00d | 27 | 17 | $729.04 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 51 | 27 | $548.18 |