NPI: 1407000870 · SUPERIOR, WI 54880 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,917 | $41K |
| 2019 | 1,119 | $22K |
| 2020 | 387 | $7K |
| 2021 | 43 | $677.35 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92340 | 1,218 | 1,192 | $26K | |
| 92014 | 451 | 442 | $18K | |
| 99214 | 192 | 192 | $9K | |
| 92015 | 1,324 | 1,308 | $8K | |
| V2020 | Vision svcs frames purchases | 171 | 170 | $7K |
| 92004 | 14 | 13 | $935.98 | |
| 92341 | 33 | 33 | $906.92 | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 29 | 29 | $475.00 |
| V2784 | Lens polycarb or equal | 34 | 34 | $300.00 |