NPI: 1336883206 · ALEXANDRIA, MN 56308 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 377 | $12K |
| 2023 | 1,551 | $54K |
| 2024 | 1,149 | $39K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 404 | 403 | $35K | |
| V2020 | Vision svcs frames purchases | 569 | 564 | $19K |
| V2100 | Lens spher single plano 4.00 | 427 | 423 | $18K |
| 92340 | 428 | 424 | $10K | |
| 92015 | 655 | 650 | $8K | |
| V2784 | Lens polycarb or equal | 500 | 498 | $8K |
| 92004 | 69 | 68 | $7K | |
| V2200 | Lens spher bifoc plano 4.00d | 12 | 12 | $469.90 |
| 92341 | 13 | 13 | $372.73 |