NPI: 1639749401 · BROOKVILLE, IN 47012 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 1,871 | $45K |
| 2023 | 3,969 | $75K |
| 2024 | 3,671 | $54K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 821 | 817 | $55K | |
| V2020 | Vision svcs frames purchases | 977 | 941 | $30K |
| 92004 | 309 | 303 | $27K | |
| 92340 | 882 | 852 | $23K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 906 | 693 | $13K |
| V2783 | Lens, >= 1.66 p/>=1.80 g | 133 | 67 | $6K |
| V2755 | Uv lens/es | 764 | 412 | $5K |
| V2784 | Lens polycarb or equal | 941 | 507 | $5K |
| V2750 | Anti-reflective coating | 897 | 642 | $5K |
| V2760 | Scratch resistant coating | 1,506 | 835 | $2K |
| V2100 | Lens spher single plano 4.00 | 44 | 36 | $637.09 |
| 92015 | 1,331 | 1,327 | $101.13 |