NPI: 1932389145 · WAGONER, OK 74467 · 152WC0802X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 491 | $17K |
| 2022 | 1,768 | $60K |
| 2023 | 1,632 | $55K |
| 2024 | 248 | $7K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 614 | 614 | $62K | |
| 92004 | 211 | 211 | $26K | |
| 92340 | 536 | 534 | $16K | |
| 92015 | 905 | 904 | $16K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 311 | 310 | $7K |
| V2020 | Vision svcs frames purchases | 675 | 672 | $7K |
| V2100 | Lens spher single plano 4.00 | 186 | 185 | $4K |
| 99212 | 12 | 12 | $543.65 | |
| 92370 | 12 | 12 | $328.44 | |
| V2784 | Lens polycarb or equal | 677 | 674 | $0.00 |