NPI: 1780766592 · ADA, OK 74820 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,114 | $26K |
| 2019 | 1,272 | $33K |
| 2020 | 877 | $21K |
| 2021 | 86 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 218 | 218 | $20K | |
| 92340 | 549 | 541 | $16K | |
| 92004 | 112 | 112 | $13K | |
| 92015 | 708 | 708 | $12K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 311 | 306 | $9K |
| V2108 | Spherocylinder 4.25d/2.12-4d | 249 | 242 | $7K |
| V2020 | Vision svcs frames purchases | 561 | 555 | $6K |
| V2784 | Lens polycarb or equal | 641 | 625 | $0.00 |