NPI: 1932884251 · PUEBLO WEST, CO 81007 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 572 | $42K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2410 | Lens variab asphericity sing | 66 | 39 | $14K |
| 92004 | 86 | 83 | $11K | |
| V2784 | Lens polycarb or equal | 87 | 52 | $7K |
| V2020 | Vision svcs frames purchases | 65 | 37 | $4K |
| V2750 | Anti-reflective coating | 66 | 39 | $2K |
| 92340 | 88 | 52 | $2K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 18 | 13 | $1K |
| 92015 | 96 | 92 | $137.56 |