NPI: 1871159244 · APPLETON, WI 54915 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 30 | $820.02 |
| 2020 | 17 | $567.02 |
| 2021 | 659 | $20K |
| 2022 | 1,369 | $42K |
| 2023 | 1,720 | $50K |
| 2024 | 1,869 | $54K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 1,753 | 1,461 | $53K |
| 92014 | 1,159 | 986 | $45K | |
| V2100 | Lens spher single plano 4.00 | 1,271 | 1,052 | $30K |
| 92004 | 725 | 654 | $26K | |
| V2784 | Lens polycarb or equal | 515 | 395 | $9K |
| V2200 | Lens spher bifoc plano 4.00d | 59 | 54 | $2K |
| 92015 | 153 | 150 | $1K | |
| 92340 | 29 | 29 | $610.13 |