NPI: 1386736726 · LOGAN, OH 43138 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 54 | $648.00 |
| 2019 | 69 | $948.00 |
| 2020 | 1,619 | $29K |
| 2021 | 977 | $20K |
| 2022 | 486 | $8K |
| 2023 | 46 | $872.48 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 508 | 508 | $22K | |
| V2020 | Vision svcs frames purchases | 723 | 715 | $12K |
| V2100 | Lens spher single plano 4.00 | 477 | 471 | $12K |
| 92004 | 188 | 187 | $8K | |
| V2784 | Lens polycarb or equal | 377 | 372 | $3K |
| 92015 | 924 | 922 | $828.00 | |
| V2200 | Lens spher bifoc plano 4.00d | 16 | 16 | $603.20 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 13 | 13 | $323.44 |
| 92340 | 13 | 13 | $208.00 | |
| V2750 | Anti-reflective coating | 12 | 12 | $0.00 |