NPI: 1336371327 · MAKAWAO, HI 96768 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 645 | $11K |
| 2019 | 1,397 | $34K |
| 2020 | 318 | $10K |
| 2021 | 514 | $13K |
| 2022 | 661 | $7K |
| 2023 | 828 | $9K |
| 2024 | 566 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 644 | 615 | $31K | |
| V2020 | Vision svcs frames purchases | 321 | 285 | $19K |
| 92015 | 2,190 | 1,796 | $17K | |
| 92004 | 146 | 136 | $9K | |
| 92340 | 207 | 186 | $5K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 70 | 63 | $3K |
| V2756 | Eye glass case | 705 | 644 | $991.62 |
| V2784 | Lens polycarb or equal | 47 | 37 | $882.12 |
| 92250 | 13 | 13 | $671.19 | |
| 92012 | 13 | 12 | $460.07 | |
| V2100 | Lens spher single plano 4.00 | 196 | 183 | $427.61 |
| V2750 | Anti-reflective coating | 104 | 95 | $263.36 |
| V2025 | Eyeglasses delux frames | 273 | 272 | $0.00 |