NPI: 1720464878 · COUNCIL BLUFFS, IA 51501 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 525 | $18K |
| 2019 | 399 | $15K |
| 2020 | 506 | $16K |
| 2021 | 673 | $18K |
| 2022 | 1,043 | $24K |
| 2023 | 127 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 439 | 399 | $34K | |
| 92014 | 372 | 329 | $23K | |
| V2020 | Vision svcs frames purchases | 891 | 833 | $13K |
| 99211 | 759 | 732 | $10K | |
| V2760 | Scratch resistant coating | 521 | 504 | $8K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 187 | 179 | $3K |
| V2100 | Lens spher single plano 4.00 | 31 | 24 | $574.67 |
| 92015 | 73 | 67 | $0.00 |