NPI: 1609157122 · BOLINGBROOK, IL 60440 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 996 | $33K |
| 2019 | 3,423 | $103K |
| 2020 | 1,797 | $53K |
| 2021 | 451 | $14K |
| 2022 | 422 | $13K |
| 2023 | 759 | $20K |
| 2024 | 617 | $16K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 3,379 | 3,287 | $152K | |
| 92015 | 3,750 | 3,667 | $56K | |
| 92340 | 706 | 679 | $20K | |
| 92014 | 272 | 265 | $12K | |
| 92012 | 138 | 108 | $6K | |
| V2025 | Eyeglasses delux frames | 64 | 56 | $2K |
| S0620 | Routine ophthalmological exa | 27 | 27 | $1K |
| V2020 | Vision svcs frames purchases | 28 | 28 | $1K |
| S0621 | Routine ophthalmological exa | 13 | 13 | $577.85 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 32 | 27 | $409.02 |
| V2784 | Lens polycarb or equal | 28 | 28 | $360.08 |
| V2100 | Lens spher single plano 4.00 | 28 | 28 | $357.34 |