NPI: 1649202284 · DODGE CITY, KS 67801 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 2,261 | $23K |
| 2019 | 2,266 | $34K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 326 | 276 | $19K | |
| V2020 | Vision svcs frames purchases | 553 | 464 | $17K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 353 | 279 | $10K |
| V2760 | Scratch resistant coating | 500 | 421 | $6K |
| 92015 | 610 | 501 | $3K | |
| 92004 | 31 | 26 | $3K | |
| S0580 | Polycarb lens | 13 | 13 | $130.00 |
| G8783 | Bp scrn perf rec interval | 664 | 548 | $0.00 |
| G8427 | Docrev cur meds by elig clin | 767 | 606 | $0.00 |
| 1036F | 710 | 573 | $0.00 |