NPI: 1609432095 · MARINETTE, WI 54143 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 27 | $854.50 |
| 2021 | 662 | $20K |
| 2022 | 1,292 | $39K |
| 2023 | 1,912 | $58K |
| 2024 | 1,906 | $54K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 1,984 | 1,573 | $57K |
| 92014 | 1,159 | 977 | $45K | |
| V2100 | Lens spher single plano 4.00 | 1,582 | 1,233 | $37K |
| 92004 | 787 | 666 | $28K | |
| V2784 | Lens polycarb or equal | 226 | 163 | $4K |
| V2200 | Lens spher bifoc plano 4.00d | 12 | 12 | $468.80 |
| 92340 | 13 | 13 | $278.21 | |
| 92015 | 36 | 28 | $240.84 |