NPI: 1740494269 · PUEBLO, CO 81008 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 4,649 | $180K |
| 2022 | 4,385 | $170K |
| 2023 | 882 | $40K |
| 2024 | 936 | $40K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 1,026 | 983 | $117K | |
| 92014 | 1,097 | 1,045 | $106K | |
| V2781 | Progressive lens per lens | 756 | 704 | $48K |
| V2020 | Vision svcs frames purchases | 1,018 | 951 | $40K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 673 | 635 | $29K |
| V2750 | Anti-reflective coating | 1,043 | 975 | $26K |
| V2784 | Lens polycarb or equal | 1,046 | 977 | $25K |
| 92340 | 1,052 | 981 | $18K | |
| V2410 | Lens variab asphericity sing | 154 | 147 | $12K |
| V2744 | Tint photochromatic lens/es | 577 | 539 | $6K |
| V2104 | Spherocylindr 4.00d/2.12-4d | 28 | 27 | $1K |
| V2100 | Lens spher single plano 4.00 | 29 | 28 | $930.15 |
| 92015 | 2,353 | 2,232 | $588.01 |