NPI: 1447345566 · OGALLALA, NE 69153 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 234 | $12K |
| 2019 | 247 | $7K |
| 2020 | 364 | $15K |
| 2021 | 548 | $23K |
| 2022 | 784 | $36K |
| 2023 | 787 | $37K |
| 2024 | 299 | $13K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92340 | 671 | 669 | $52K | |
| 92014 | 646 | 644 | $41K | |
| 92015 | 1,274 | 1,261 | $21K | |
| V2100 | Lens spher single plano 4.00 | 364 | 364 | $15K |
| 92004 | 90 | 90 | $7K | |
| V2020 | Vision svcs frames purchases | 173 | 172 | $6K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 18 | 18 | $800.00 |
| V2784 | Lens polycarb or equal | 27 | 27 | $601.02 |