NPI: 1720253271 · MISSION, KS 66202 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,324 | $43K |
| 2019 | 271 | $8K |
| 2020 | 204 | $1K |
| 2021 | 199 | $7K |
| 2022 | 204 | $31.50 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2101 | Single visn sphere 4.12-7.00 | 496 | 486 | $20K |
| V2020 | Vision svcs frames purchases | 708 | 677 | $20K |
| 92014 | 100 | 97 | $6K | |
| 92004 | 51 | 49 | $5K | |
| V2784 | Lens polycarb or equal | 105 | 101 | $4K |
| 92015 | 549 | 517 | $2K | |
| S0580 | Polycarb lens | 128 | 127 | $1K |
| 92012 | 12 | 12 | $600.12 | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 29 | 28 | $0.00 |
| V2783 | Lens, >= 1.66 p/>=1.80 g | 24 | 24 | $0.00 |