NPI: 1912091554 · SOUTH SIOUX CITY, NE 68776 · 332H00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 3,921 | $109K |
| 2019 | 3,913 | $108K |
| 2020 | 2,652 | $74K |
| 2021 | 4,494 | $123K |
| 2022 | 4,026 | $109K |
| 2023 | 4,055 | $115K |
| 2024 | 1,923 | $45K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92340 | 4,304 | 4,113 | $217K | |
| 92012 | 3,458 | 3,329 | $123K | |
| V2020 | Vision svcs frames purchases | 3,174 | 3,009 | $113K |
| 92015 | 5,775 | 5,453 | $93K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 2,232 | 2,121 | $63K |
| V2784 | Lens polycarb or equal | 1,953 | 1,831 | $43K |
| 92002 | 623 | 606 | $27K | |
| V2756 | Eye glass case | 3,384 | 3,233 | $4K |
| V2104 | Spherocylindr 4.00d/2.12-4d | 66 | 63 | $2K |
| V2100 | Lens spher single plano 4.00 | 15 | 14 | $258.60 |