NPI: 1760894935 · JACKSONVILLE, IL 62650 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 69 | $1K |
| 2020 | 793 | $19K |
| 2021 | 1,738 | $42K |
| 2022 | 4,241 | $99K |
| 2023 | 7,645 | $181K |
| 2024 | 6,908 | $172K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 2,720 | 2,572 | $117K | |
| 92015 | 4,854 | 4,514 | $81K | |
| 92340 | 2,875 | 2,710 | $79K | |
| 92004 | 1,661 | 1,556 | $77K | |
| V2100 | Lens spher single plano 4.00 | 2,151 | 2,072 | $39K |
| V2020 | Vision svcs frames purchases | 2,773 | 2,637 | $35K |
| V2025 | Eyeglasses delux frames | 664 | 646 | $33K |
| V2784 | Lens polycarb or equal | 2,448 | 2,345 | $27K |
| 92341 | 470 | 462 | $14K | |
| V2200 | Lens spher bifoc plano 4.00d | 252 | 246 | $7K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 473 | 429 | $5K |
| 99212 | 39 | 39 | $460.75 | |
| 99213 | 14 | 14 | $0.00 |