NPI: 1558648006 · WAUKESHA, WI 53188 · 332H00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,422 | $31K |
| 2019 | 917 | $23K |
| 2020 | 6,267 | $77K |
| 2021 | 1,126 | $22K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92340 | 2,444 | 2,264 | $35K | |
| 92004 | 1,005 | 932 | $33K | |
| V2020 | Vision svcs frames purchases | 2,551 | 2,326 | $33K |
| 92014 | 698 | 665 | $23K | |
| V2100 | Lens spher single plano 4.00 | 1,842 | 1,678 | $14K |
| 92341 | 593 | 564 | $11K | |
| V2200 | Lens spher bifoc plano 4.00d | 324 | 299 | $4K |
| 92250 | 229 | 164 | $285.00 | |
| V2784 | Lens polycarb or equal | 13 | 13 | $108.00 |
| V2799 | Misc vision item or service | 12 | 12 | $0.00 |
| 92310 | 21 | 16 | $0.00 |