NPI: 1265020143 · COLDWATER, MI 49036 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 1,472 | $29K |
| 2022 | 2,055 | $37K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 373 | 373 | $20K | |
| V2020 | Vision svcs frames purchases | 630 | 626 | $12K |
| 92014 | 217 | 213 | $10K | |
| 92015 | 801 | 796 | $6K | |
| 92340 | 453 | 449 | $6K | |
| V2784 | Lens polycarb or equal | 413 | 402 | $3K |
| 99204 | 42 | 42 | $3K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 245 | 227 | $2K |
| 92341 | 97 | 96 | $2K | |
| V2100 | Lens spher single plano 4.00 | 205 | 190 | $1K |
| 99212 | 12 | 12 | $348.50 | |
| V2755 | Uv lens/es | 26 | 26 | $2.15 |
| V2760 | Scratch resistant coating | 13 | 13 | $0.00 |