NPI: 1992898894 · EVANSTON, WY 82930 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 528 | $31K |
| 2019 | 970 | $58K |
| 2020 | 921 | $55K |
| 2021 | 565 | $31K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 606 | 602 | $58K | |
| 92004 | 337 | 334 | $39K | |
| V2020 | Vision svcs frames purchases | 494 | 491 | $34K |
| V2784 | Lens polycarb or equal | 473 | 471 | $20K |
| 92015 | 939 | 931 | $17K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 98 | 95 | $5K |
| V2101 | Single visn sphere 4.12-7.00 | 24 | 24 | $909.18 |
| V2100 | Lens spher single plano 4.00 | 13 | 13 | $601.75 |