NPI: 1235343765 · PUEBLO, CO 81004 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 11,321 | $246K |
| 2022 | 8,329 | $303K |
| 2023 | 4,381 | $185K |
| 2024 | 1,349 | $57K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 2,590 | 2,098 | $204K | |
| 92004 | 1,727 | 1,399 | $160K | |
| V2781 | Progressive lens per lens | 1,773 | 1,268 | $84K |
| V2020 | Vision svcs frames purchases | 2,485 | 1,919 | $76K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 1,610 | 1,245 | $54K |
| V2750 | Anti-reflective coating | 2,574 | 1,997 | $52K |
| V2784 | Lens polycarb or equal | 2,583 | 2,005 | $46K |
| V2410 | Lens variab asphericity sing | 606 | 569 | $42K |
| 92340 | 2,594 | 2,010 | $36K | |
| V2104 | Spherocylindr 4.00d/2.12-4d | 467 | 344 | $17K |
| V2744 | Tint photochromatic lens/es | 1,614 | 1,260 | $15K |
| 99213 | 64 | 56 | $3K | |
| V2100 | Lens spher single plano 4.00 | 65 | 37 | $1K |
| 92015 | 4,628 | 3,738 | $963.25 |