NPI: 1689840027 · SALEM, MO 65560 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 491 | $5K |
| 2019 | 512 | $6K |
| 2020 | 1,004 | $20K |
| 2021 | 1,391 | $30K |
| 2022 | 1,544 | $56K |
| 2023 | 1,672 | $80K |
| 2024 | 923 | $46K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 957 | 945 | $68K | |
| V2020 | Vision svcs frames purchases | 1,981 | 1,962 | $66K |
| 92004 | 658 | 649 | $56K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 488 | 403 | $18K |
| V2784 | Lens polycarb or equal | 333 | 320 | $13K |
| 92015 | 2,819 | 2,782 | $13K | |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 123 | 80 | $4K |
| 92250 | 89 | 89 | $1K | |
| 99213 | 75 | 75 | $1K | |
| V2100 | Lens spher single plano 4.00 | 14 | 13 | $272.16 |