NPI: 1740854389 · NORTHWOOD, OH 43619 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 449 | $4K |
| 2023 | 354 | $2K |
| 2024 | 392 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92340 | 124 | 123 | $3K | |
| V2020 | Vision svcs frames purchases | 347 | 344 | $2K |
| V2100 | Lens spher single plano 4.00 | 81 | 81 | $1K |
| 92015 | 339 | 339 | $1K | |
| 92014 | 41 | 41 | $601.44 | |
| 92004 | 41 | 41 | $515.52 | |
| V2784 | Lens polycarb or equal | 162 | 160 | $169.00 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 60 | 60 | $0.00 |