NPI: 1588738132 · ALEXANDRIA, MN 56308 · 156FX1800X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,482 | $6K |
| 2019 | 356 | $11K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 251 | 243 | $7K | |
| V2020 | Vision svcs frames purchases | 393 | 377 | $4K |
| 92340 | 253 | 244 | $2K | |
| 92015 | 393 | 382 | $2K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 225 | 218 | $2K |
| V2784 | Lens polycarb or equal | 297 | 285 | $979.65 |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 13 | 12 | $0.00 |
| 92004 | 13 | 13 | $0.00 |