NPI: 1821755398 · LINCOLN, NE 68505 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 1,500 | $68K |
| 2023 | 1,913 | $84K |
| 2024 | 1,677 | $66K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92340 | 1,199 | 1,171 | $54K | |
| V2100 | Lens spher single plano 4.00 | 1,249 | 1,226 | $50K |
| 92014 | 775 | 735 | $48K | |
| V2020 | Vision svcs frames purchases | 865 | 838 | $33K |
| 92004 | 264 | 259 | $19K | |
| 92015 | 658 | 611 | $11K | |
| 92012 | 24 | 24 | $787.86 | |
| V2200 | Lens spher bifoc plano 4.00d | 14 | 14 | $680.31 |
| 92341 | 13 | 13 | $633.17 | |
| 92002 | 16 | 16 | $537.60 | |
| V2784 | Lens polycarb or equal | 13 | 13 | $79.62 |