NPI: 1528082070 · MANISTEE, MI 49660 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 24 | $620.52 |
| 2022 | 108 | $2K |
| 2023 | 1,932 | $39K |
| 2024 | 2,052 | $40K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 911 | 909 | $22K |
| V2020 | Vision svcs frames purchases | 984 | 982 | $20K |
| 92012 | 249 | 249 | $12K | |
| 92014 | 210 | 210 | $10K | |
| V2784 | Lens polycarb or equal | 1,092 | 1,090 | $7K |
| 92004 | 102 | 102 | $5K | |
| 92002 | 44 | 44 | $2K | |
| V2200 | Lens spher bifoc plano 4.00d | 45 | 45 | $1K |
| V2025 | Eyeglasses delux frames | 56 | 56 | $1K |
| 92340 | 12 | 12 | $237.72 | |
| 92015 | 411 | 405 | $0.00 |