NPI: 1265636922 · SHAWNEE, OK 74804 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 509 | $17K |
| 2022 | 1,909 | $66K |
| 2023 | 1,927 | $66K |
| 2024 | 632 | $25K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 1,157 | 1,157 | $89K | |
| 92004 | 285 | 285 | $27K | |
| 92340 | 638 | 637 | $19K | |
| 92015 | 1,073 | 1,072 | $17K | |
| V2100 | Lens spher single plano 4.00 | 540 | 538 | $15K |
| V2020 | Vision svcs frames purchases | 621 | 619 | $6K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 31 | 31 | $864.90 |
| V2784 | Lens polycarb or equal | 632 | 630 | $0.00 |