NPI: 1346620432 · FORT DODGE, IA 50501 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 55 | $1K |
| 2019 | 272 | $9K |
| 2020 | 161 | $2K |
| 2021 | 272 | $9K |
| 2022 | 706 | $19K |
| 2023 | 636 | $18K |
| 2024 | 880 | $17K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 629 | 570 | $34K | |
| V2020 | Vision svcs frames purchases | 831 | 695 | $18K |
| 92004 | 134 | 122 | $11K | |
| V2100 | Lens spher single plano 4.00 | 414 | 345 | $8K |
| 92015 | 151 | 141 | $2K | |
| V2784 | Lens polycarb or equal | 562 | 481 | $1K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 18 | 15 | $357.28 |
| V2756 | Eye glass case | 243 | 227 | $236.97 |