NPI: 1447298344 · WAILUKU, HI 96793 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 4,205 | $124K |
| 2019 | 5,028 | $175K |
| 2020 | 4,370 | $153K |
| 2021 | 5,430 | $186K |
| 2022 | 5,125 | $99K |
| 2023 | 4,999 | $107K |
| 2024 | 5,369 | $97K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 7,490 | 6,954 | $358K | |
| V2020 | Vision svcs frames purchases | 2,244 | 2,077 | $136K |
| 92004 | 1,462 | 1,375 | $98K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 2,023 | 1,701 | $96K |
| 92015 | 9,660 | 8,582 | $91K | |
| 92340 | 1,759 | 1,653 | $47K | |
| 99214 | 346 | 304 | $25K | |
| V2784 | Lens polycarb or equal | 641 | 596 | $24K |
| 92012 | 619 | 532 | $23K | |
| 99072 | 824 | 755 | $13K | |
| 92134 | 521 | 485 | $13K | |
| 99213 | 89 | 79 | $6K | |
| V2756 | Eye glass case | 3,704 | 3,493 | $6K |
| V2025 | Eyeglasses delux frames | 1,095 | 1,087 | $4K |
| 67028 | 21 | 13 | $2K | |
| 92136 | 20 | 12 | $643.74 | |
| 92310 | 27 | 25 | $283.32 | |
| V2100 | Lens spher single plano 4.00 | 690 | 685 | $210.99 |
| S9999 | Sales tax | 1,034 | 886 | $26.10 |
| V2750 | Anti-reflective coating | 188 | 180 | $0.00 |
| V2760 | Scratch resistant coating | 25 | 25 | $0.00 |
| V2755 | Uv lens/es | 44 | 44 | $0.00 |