NPI: 1629390612 · THORNTON, CO 80233 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 347 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 41 | 39 | $1K |
| 92340 | 43 | 41 | $701.02 | |
| V2784 | Lens polycarb or equal | 43 | 41 | $588.00 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 15 | 15 | $535.21 |
| V2750 | Anti-reflective coating | 13 | 13 | $282.96 |
| 92015 | 126 | 125 | $0.00 | |
| 92014 | 29 | 29 | $0.00 | |
| 92004 | 37 | 37 | $0.00 |