NPI: 1003144833 · FORT LEE, NJ 07024 · 332H00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 483 | $208.00 |
| 2020 | 801 | $78.00 |
| 2021 | 1,032 | $26.00 |
| 2022 | 504 | $0.00 |
| 2023 | 561 | $0.00 |
| 2024 | 214 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 577 | 567 | $312.00 | |
| V2784 | Lens polycarb or equal | 654 | 320 | $0.00 |
| 92004 | 216 | 216 | $0.00 | |
| V2100 | Lens spher single plano 4.00 | 896 | 440 | $0.00 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 60 | 30 | $0.00 |
| V2020 | Vision svcs frames purchases | 600 | 593 | $0.00 |
| V2750 | Anti-reflective coating | 592 | 291 | $0.00 |