NPI: 1952967325 · GRAND ISLAND, NE 68803 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 12 | $526.52 |
| 2021 | 2,470 | $86K |
| 2022 | 3,742 | $152K |
| 2023 | 5,080 | $216K |
| 2024 | 3,907 | $159K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92340 | 3,144 | 3,028 | $153K | |
| V2020 | Vision svcs frames purchases | 2,987 | 2,801 | $116K |
| V2100 | Lens spher single plano 4.00 | 3,002 | 2,891 | $108K |
| 92014 | 1,515 | 1,427 | $94K | |
| 92004 | 773 | 748 | $57K | |
| 92015 | 2,109 | 1,931 | $34K | |
| V2200 | Lens spher bifoc plano 4.00d | 211 | 199 | $12K |
| 92012 | 379 | 340 | $11K | |
| V2784 | Lens polycarb or equal | 648 | 584 | $11K |
| 92002 | 283 | 283 | $9K | |
| 92341 | 160 | 154 | $9K |