NPI: 1366753238 · SAINT PETERS, MO 63376 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 3,859 | $56K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2784 | Lens polycarb or equal | 1,036 | 606 | $14K |
| V2020 | Vision svcs frames purchases | 862 | 635 | $13K |
| 92014 | 222 | 177 | $9K | |
| 92004 | 232 | 170 | $8K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 719 | 442 | $6K |
| V2100 | Lens spher single plano 4.00 | 229 | 147 | $2K |
| 92015 | 442 | 340 | $2K | |
| V2104 | Spherocylindr 4.00d/2.12-4d | 84 | 55 | $1K |
| V2107 | Spherocylinder 4.25d/12-2d | 33 | 26 | $631.50 |