NPI: 1538152558 · ELK GROVE VILLAGE, IL 60007 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 620 | $26K |
| 2021 | 929 | $39K |
| 2022 | 2,319 | $60K |
| 2023 | 2,505 | $58K |
| 2024 | 2,067 | $54K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 1,317 | 1,253 | $44K |
| V2020 | Vision svcs frames purchases | 1,427 | 1,359 | $43K |
| 92004 | 990 | 929 | $42K | |
| 92014 | 937 | 899 | $39K | |
| 92012 | 523 | 513 | $24K | |
| 92015 | 1,560 | 1,542 | $17K | |
| 92340 | 757 | 716 | $16K | |
| V2784 | Lens polycarb or equal | 889 | 823 | $11K |
| V2025 | Eyeglasses delux frames | 13 | 13 | $520.00 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 27 | 27 | $293.48 |