NPI: 1770958415 · BOULDER, CO 80302 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 204 | $8K |
| 2020 | 238 | $9K |
| 2021 | 590 | $22K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92250 | 372 | 337 | $19K | |
| 99204 | 122 | 113 | $15K | |
| V2410 | Lens variab asphericity sing | 30 | 26 | $2K |
| V2020 | Vision svcs frames purchases | 31 | 27 | $1K |
| 92340 | 30 | 26 | $503.53 | |
| V2750 | Anti-reflective coating | 29 | 26 | $502.14 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 13 | 12 | $477.00 |
| V2784 | Lens polycarb or equal | 31 | 27 | $326.32 |
| 92015 | 374 | 342 | $139.53 |