NPI: 1750315040 · SPIRIT LAKE, IA 51360 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 428 | $16K |
| 2020 | 433 | $20K |
| 2021 | 483 | $21K |
| 2022 | 833 | $35K |
| 2023 | 914 | $42K |
| 2024 | 1,204 | $43K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 1,981 | 1,925 | $129K | |
| 92015 | 1,401 | 1,382 | $20K | |
| 92012 | 255 | 254 | $12K | |
| V2020 | Vision svcs frames purchases | 394 | 371 | $11K |
| 92002 | 25 | 25 | $1K | |
| 92004 | 12 | 12 | $1K | |
| 99213 | 29 | 26 | $760.04 | |
| V2100 | Lens spher single plano 4.00 | 28 | 14 | $469.68 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 21 | 14 | $319.00 |
| V2756 | Eye glass case | 149 | 148 | $164.22 |