NPI: 1417033457 · BOLINGBROOK, IL 60490 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 291 | $9K |
| 2022 | 732 | $21K |
| 2023 | 1,273 | $34K |
| 2024 | 1,710 | $48K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 749 | 744 | $34K | |
| 92015 | 1,378 | 1,368 | $21K | |
| 92014 | 457 | 455 | $20K | |
| V2020 | Vision svcs frames purchases | 428 | 427 | $16K |
| 92340 | 511 | 508 | $15K | |
| V2784 | Lens polycarb or equal | 343 | 342 | $4K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 96 | 96 | $1K |
| V2100 | Lens spher single plano 4.00 | 44 | 44 | $558.40 |