NPI: 1669524054 · GRAYSLAKE, IL 60030 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 55 | $3K |
| 2021 | 38 | $2K |
| 2022 | 389 | $9K |
| 2023 | 168 | $3K |
| 2024 | 841 | $24K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 192 | 178 | $8K | |
| 92004 | 155 | 153 | $8K | |
| V2020 | Vision svcs frames purchases | 194 | 171 | $7K |
| 92015 | 528 | 525 | $7K | |
| 92012 | 81 | 76 | $4K | |
| 92340 | 106 | 88 | $3K | |
| V2784 | Lens polycarb or equal | 142 | 121 | $2K |
| V2100 | Lens spher single plano 4.00 | 71 | 53 | $2K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 22 | 22 | $242.44 |