NPI: 1710964309 · BOLIVAR, MO 65613 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 490 | $9K |
| 2019 | 98 | $2K |
| 2020 | 1,164 | $20K |
| 2021 | 2,024 | $38K |
| 2022 | 2,752 | $86K |
| 2023 | 1,673 | $73K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 951 | 933 | $75K | |
| V2020 | Vision svcs frames purchases | 1,840 | 1,813 | $54K |
| 92014 | 709 | 699 | $44K | |
| V2784 | Lens polycarb or equal | 1,359 | 1,331 | $24K |
| 92015 | 2,316 | 2,286 | $12K | |
| V2100 | Lens spher single plano 4.00 | 648 | 643 | $9K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 221 | 212 | $5K |
| V2200 | Lens spher bifoc plano 4.00d | 67 | 65 | $3K |
| 92250 | 52 | 51 | $1K | |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 25 | 24 | $1K |
| G8427 | Docrev cur meds by elig clin | 13 | 13 | $0.00 |