NPI: 1982706636 · BOLINGBROOK, IL 60440 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 4,000 | $153K |
| 2019 | 2,092 | $80K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 1,850 | 666 | $98K |
| 92014 | 1,223 | 455 | $55K | |
| 92004 | 1,188 | 479 | $53K | |
| V2025 | Eyeglasses delux frames | 1,627 | 586 | $18K |
| S0621 | Routine ophthalmological exa | 91 | 91 | $4K |
| S0620 | Routine ophthalmological exa | 85 | 85 | $4K |
| V2784 | Lens polycarb or equal | 28 | 28 | $0.00 |