NPI: 1346331089 · GARDEN CITY, KS 67846 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 2,090 | $70K |
| 2019 | 887 | $34K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 698 | 657 | $23K |
| 92014 | 309 | 299 | $21K | |
| 92004 | 232 | 219 | $21K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 575 | 543 | $20K |
| V2784 | Lens polycarb or equal | 258 | 245 | $12K |
| 92015 | 854 | 820 | $5K | |
| 92012 | 24 | 24 | $1K | |
| V2782 | Lens, 1.54-1.65 p/1.60-1.79g | 14 | 14 | $939.96 |
| V2100 | Lens spher single plano 4.00 | 13 | 13 | $650.00 |