NPI: 1568568384 · COUNCIL BLUFFS, IA 51501 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 1,083 | $17K |
| 2023 | 1,738 | $35K |
| 2024 | 559 | $14K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 916 | 513 | $35K | |
| V2020 | Vision svcs frames purchases | 533 | 514 | $14K |
| 92004 | 139 | 73 | $7K | |
| 99214 | 63 | 52 | $3K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 200 | 159 | $3K |
| 92285 | 72 | 52 | $2K | |
| 92250 | 28 | 26 | $1K | |
| V2784 | Lens polycarb or equal | 163 | 160 | $282.16 |
| V2100 | Lens spher single plano 4.00 | 12 | 12 | $267.96 |
| 92015 | 1,254 | 728 | $0.00 |