NPI: 1598115784 · O FALLON, MO 63366 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 443 | $10K |
| 2020 | 3,836 | $111K |
| 2021 | 1,581 | $43K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 638 | 630 | $39K | |
| 92004 | 427 | 407 | $33K | |
| V2020 | Vision svcs frames purchases | 1,019 | 939 | $29K |
| 92015 | 1,238 | 1,189 | $26K | |
| 92340 | 793 | 753 | $20K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 557 | 529 | $10K |
| V2784 | Lens polycarb or equal | 957 | 897 | $6K |
| V2100 | Lens spher single plano 4.00 | 188 | 179 | $2K |
| 92250 | 26 | 26 | $474.72 | |
| V2755 | Uv lens/es | 17 | 17 | $10.00 |