NPI: 1174738603 · ALAMOSA, CO 81101 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 9,116 | $263K |
| 2022 | 9,344 | $330K |
| 2023 | 9,426 | $440K |
| 2024 | 3,245 | $167K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 2,413 | 2,185 | $216K | |
| 92004 | 1,695 | 1,500 | $171K | |
| V2020 | Vision svcs frames purchases | 3,499 | 2,982 | $144K |
| V2410 | Lens variab asphericity sing | 1,663 | 1,466 | $126K |
| V2784 | Lens polycarb or equal | 3,525 | 3,001 | $118K |
| V2781 | Progressive lens per lens | 1,798 | 1,480 | $96K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 2,219 | 1,869 | $92K |
| V2750 | Anti-reflective coating | 3,504 | 2,985 | $87K |
| 92340 | 3,630 | 3,070 | $59K | |
| V2104 | Spherocylindr 4.00d/2.12-4d | 838 | 709 | $38K |
| V2744 | Tint photochromatic lens/es | 1,587 | 1,409 | $27K |
| V2100 | Lens spher single plano 4.00 | 441 | 396 | $17K |
| V2105 | Spherocylinder 4.00d/4.25-6d | 128 | 91 | $5K |
| 92015 | 4,165 | 3,701 | $2K | |
| 99213 | 13 | 13 | $534.96 | |
| 99212 | 13 | 12 | $361.02 |