NPI: 1194714121 · CHICAGO HEIGHTS, IL 60411 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 2,568 | $92K |
| 2019 | 917 | $25K |
| 2020 | 176 | $5K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 633 | 563 | $27K | |
| V2100 | Lens spher single plano 4.00 | 535 | 409 | $24K |
| V2200 | Lens spher bifoc plano 4.00d | 163 | 109 | $16K |
| 92004 | 285 | 242 | $13K | |
| 92340 | 422 | 403 | $12K | |
| 92015 | 590 | 567 | $10K | |
| V2020 | Vision svcs frames purchases | 294 | 273 | $6K |
| S0621 | Routine ophthalmological exa | 111 | 111 | $5K |
| V2025 | Eyeglasses delux frames | 407 | 266 | $5K |
| S0620 | Routine ophthalmological exa | 71 | 71 | $3K |
| 92012 | 14 | 14 | $630.00 | |
| V2784 | Lens polycarb or equal | 123 | 123 | $385.00 |
| V2781 | Progressive lens per lens | 13 | 13 | $0.00 |