NPI: 1710965629 · DAVENPORT, IA 52807 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 3,191 | $99K |
| 2019 | 3,731 | $108K |
| 2020 | 1,985 | $72K |
| 2021 | 2,671 | $95K |
| 2022 | 1,569 | $54K |
| 2023 | 12 | $780.85 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 2,105 | 1,859 | $170K | |
| 92014 | 2,238 | 1,919 | $129K | |
| V2020 | Vision svcs frames purchases | 2,808 | 2,316 | $58K |
| V2100 | Lens spher single plano 4.00 | 2,336 | 1,941 | $46K |
| 92015 | 1,138 | 1,067 | $15K | |
| 99213 | 176 | 138 | $6K | |
| V2756 | Eye glass case | 2,277 | 1,853 | $2K |
| 92083 | 39 | 26 | $1K | |
| V2200 | Lens spher bifoc plano 4.00d | 42 | 28 | $922.42 |