NPI: 1982894176 · BOLINGBROOK, IL 60490 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 42 | $943.13 |
| 2019 | 711 | $15K |
| 2020 | 877 | $15K |
| 2021 | 253 | $6K |
| 2022 | 155 | $3K |
| 2023 | 370 | $8K |
| 2024 | 508 | $13K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92015 | 1,449 | 1,272 | $26K | |
| 92340 | 471 | 332 | $13K | |
| 92014 | 236 | 209 | $10K | |
| 92004 | 185 | 175 | $9K | |
| V2020 | Vision svcs frames purchases | 356 | 250 | $2K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 80 | 60 | $482.95 |
| V2784 | Lens polycarb or equal | 112 | 67 | $187.18 |
| V2782 | Lens, 1.54-1.65 p/1.60-1.79g | 27 | 15 | $131.29 |