NPI: 1235406505 · MAPLEWOOD, MN 55109 · 332H00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 4,260 | $24K |
| 2019 | 6,164 | $119K |
| 2020 | 3,607 | $70K |
| 2021 | 4,517 | $105K |
| 2022 | 3,339 | $64K |
| 2023 | 4,596 | $127K |
| 2024 | 4,842 | $141K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 8,536 | 7,418 | $186K |
| V2100 | Lens spher single plano 4.00 | 10,999 | 6,784 | $141K |
| V2784 | Lens polycarb or equal | 7,466 | 5,400 | $131K |
| 92014 | 1,242 | 1,215 | $90K | |
| 92004 | 984 | 945 | $63K | |
| 92340 | 557 | 495 | $12K | |
| V2200 | Lens spher bifoc plano 4.00d | 628 | 443 | $11K |
| 92250 | 409 | 392 | $8K | |
| V2799 | Misc vision item or service | 440 | 234 | $4K |
| 92341 | 64 | 64 | $2K |