NPI: 1174159842 · LA JUNTA, CO 81050 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 1,255 | $57K |
| 2021 | 2,427 | $110K |
| 2022 | 2,121 | $101K |
| 2023 | 8,048 | $492K |
| 2024 | 8,442 | $586K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2410 | Lens variab asphericity sing | 2,939 | 1,862 | $511K |
| 92004 | 1,649 | 1,525 | $188K | |
| V2784 | Lens polycarb or equal | 3,039 | 1,924 | $159K |
| V2020 | Vision svcs frames purchases | 3,063 | 1,940 | $152K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 1,943 | 1,209 | $102K |
| V2750 | Anti-reflective coating | 3,037 | 1,922 | $86K |
| 92014 | 673 | 631 | $69K | |
| 92340 | 3,061 | 1,934 | $65K | |
| V2104 | Spherocylindr 4.00d/2.12-4d | 158 | 97 | $8K |
| V2100 | Lens spher single plano 4.00 | 59 | 39 | $3K |
| 92015 | 2,632 | 2,405 | $1K | |
| 92250 | 22 | 14 | $552.72 | |
| V2744 | Tint photochromatic lens/es | 18 | 13 | $509.66 |