NPI: 1568414829 · CAPE GIRARDEAU, MO 63703 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 4,620 | $72K |
| 2019 | 2,945 | $64K |
| 2020 | 458 | $10K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 1,495 | 1,280 | $59K | |
| 92004 | 978 | 835 | $41K | |
| V2784 | Lens polycarb or equal | 613 | 435 | $12K |
| 92015 | 2,453 | 2,101 | $12K | |
| V2020 | Vision svcs frames purchases | 708 | 514 | $9K |
| 92340 | 1,268 | 1,234 | $8K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 382 | 255 | $4K |
| V2100 | Lens spher single plano 4.00 | 126 | 66 | $1K |