NPI: 1962526889 · BLOOMINGDALE, IL 60108 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 49 | $1K |
| 2024 | 2,498 | $65K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 483 | 472 | $25K | |
| 92015 | 754 | 729 | $13K | |
| 92340 | 392 | 366 | $11K | |
| 92014 | 170 | 162 | $8K | |
| V2020 | Vision svcs frames purchases | 295 | 274 | $5K |
| V2784 | Lens polycarb or equal | 203 | 191 | $2K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 175 | 163 | $2K |
| V2100 | Lens spher single plano 4.00 | 75 | 69 | $736.59 |