NPI: 1831478338 · BELLEVUE, NE 68123 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,596 | $48K |
| 2019 | 2,213 | $62K |
| 2020 | 1,797 | $46K |
| 2021 | 2,062 | $55K |
| 2022 | 553 | $15K |
| 2024 | 642 | $22K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92340 | 2,260 | 2,218 | $88K | |
| V2020 | Vision svcs frames purchases | 1,552 | 1,511 | $58K |
| 92015 | 1,955 | 1,831 | $30K | |
| 92012 | 601 | 587 | $21K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 699 | 681 | $20K |
| 92002 | 347 | 343 | $15K | |
| V2784 | Lens polycarb or equal | 395 | 384 | $8K |
| V2100 | Lens spher single plano 4.00 | 117 | 113 | $3K |
| 92014 | 73 | 45 | $3K | |
| 92004 | 33 | 33 | $2K | |
| V2756 | Eye glass case | 831 | 803 | $906.88 |