NPI: 1720019029 · JEFFERSON, IA 50129 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,160 | $28K |
| 2019 | 577 | $18K |
| 2020 | 386 | $7K |
| 2021 | 249 | $4K |
| 2022 | 335 | $7K |
| 2023 | 169 | $2K |
| 2024 | 128 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 530 | 514 | $34K | |
| V2020 | Vision svcs frames purchases | 645 | 619 | $16K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 350 | 329 | $9K |
| 92004 | 84 | 84 | $8K | |
| V2100 | Lens spher single plano 4.00 | 54 | 54 | $1K |
| V2784 | Lens polycarb or equal | 173 | 170 | $476.40 |
| V2756 | Eye glass case | 407 | 395 | $423.36 |
| 92015 | 761 | 741 | $75.25 |