NPI: 1366002461 · WABASH, IN 46992 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 3,331 | $57K |
| 2021 | 965 | $13K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 408 | 408 | $18K | |
| 92340 | 678 | 671 | $15K | |
| 92015 | 658 | 658 | $14K | |
| 92004 | 234 | 234 | $12K | |
| 99214 | 134 | 131 | $9K | |
| 99213 | 55 | 53 | $2K | |
| 92341 | 43 | 43 | $1K | |
| V2020 | Vision svcs frames purchases | 730 | 722 | $0.00 |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 14 | 14 | $0.00 |
| V2784 | Lens polycarb or equal | 774 | 767 | $0.00 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 436 | 432 | $0.00 |
| V2100 | Lens spher single plano 4.00 | 119 | 118 | $0.00 |
| V2104 | Spherocylindr 4.00d/2.12-4d | 13 | 13 | $0.00 |