NPI: 1922536085 · PROVO, UT 84606 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 824 | $18K |
| 2021 | 1,675 | $40K |
| 2022 | 1,238 | $29K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2025 | Eyeglasses delux frames | 767 | 767 | $38K |
| 92340 | 896 | 879 | $13K | |
| V2020 | Vision svcs frames purchases | 484 | 444 | $13K |
| 92004 | 191 | 177 | $8K | |
| 92014 | 161 | 142 | $7K | |
| V2100 | Lens spher single plano 4.00 | 316 | 288 | $6K |
| 92015 | 105 | 92 | $1K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 496 | 460 | $536.75 |
| V2784 | Lens polycarb or equal | 284 | 282 | $42.00 |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 13 | 12 | $16.00 |
| V2750 | Anti-reflective coating | 24 | 24 | $0.00 |