NPI: 1225031560 · HIAWATHA, KS 66434 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 119 | $2K |
| 2020 | 118 | $3K |
| 2021 | 1,067 | $19K |
| 2022 | 1,097 | $25K |
| 2023 | 489 | $12K |
| 2024 | 143 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 793 | 692 | $30K |
| 92015 | 1,214 | 1,060 | $10K | |
| 92014 | 223 | 212 | $10K | |
| V2100 | Lens spher single plano 4.00 | 225 | 96 | $4K |
| 92340 | 66 | 51 | $4K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 107 | 57 | $2K |
| V2784 | Lens polycarb or equal | 42 | 38 | $1K |
| 92004 | 13 | 13 | $1K | |
| S0580 | Polycarb lens | 104 | 90 | $860.00 |
| V2756 | Eye glass case | 246 | 195 | $237.53 |