NPI: 1881850402 · EL DORADO, KS 67042 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 889 | $22K |
| 2019 | 1,635 | $59K |
| 2020 | 118 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 780 | 756 | $29K |
| 92014 | 315 | 306 | $22K | |
| V2100 | Lens spher single plano 4.00 | 270 | 266 | $12K |
| 92004 | 57 | 57 | $6K | |
| S0580 | Polycarb lens | 405 | 394 | $4K |
| V2784 | Lens polycarb or equal | 71 | 71 | $4K |
| 92015 | 572 | 556 | $3K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 76 | 76 | $3K |
| V2760 | Scratch resistant coating | 96 | 95 | $2K |