NPI: 1972958395 · FOUNTAIN, CO 80817 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 4,655 | $165K |
| 2022 | 3,157 | $104K |
| 2023 | 1,287 | $44K |
| 2024 | 935 | $41K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 991 | 933 | $94K | |
| 92004 | 637 | 606 | $73K | |
| V2781 | Progressive lens per lens | 740 | 653 | $44K |
| V2020 | Vision svcs frames purchases | 1,064 | 914 | $39K |
| V2750 | Anti-reflective coating | 1,049 | 892 | $25K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 543 | 481 | $22K |
| V2784 | Lens polycarb or equal | 1,048 | 900 | $20K |
| 92340 | 1,124 | 954 | $18K | |
| V2410 | Lens variab asphericity sing | 178 | 135 | $13K |
| V2744 | Tint photochromatic lens/es | 428 | 368 | $5K |
| V2100 | Lens spher single plano 4.00 | 32 | 27 | $1K |
| 92015 | 2,200 | 2,076 | $487.85 |