NPI: 1760048136 · BELLEVUE, NE 68123 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 1,240 | $48K |
| 2021 | 2,135 | $76K |
| 2022 | 4,804 | $203K |
| 2023 | 4,361 | $177K |
| 2024 | 4,368 | $168K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92340 | 3,961 | 3,751 | $180K | |
| V2100 | Lens spher single plano 4.00 | 4,526 | 4,306 | $164K |
| V2020 | Vision svcs frames purchases | 3,452 | 3,203 | $109K |
| 92014 | 1,490 | 1,487 | $95K | |
| 92004 | 986 | 979 | $75K | |
| 92015 | 1,672 | 1,548 | $27K | |
| V2784 | Lens polycarb or equal | 491 | 422 | $9K |
| 92002 | 144 | 131 | $5K | |
| 92012 | 172 | 138 | $5K | |
| V2200 | Lens spher bifoc plano 4.00d | 14 | 12 | $737.22 |