NPI: 1003853383 · WHITEHALL, PA 18052 · 332H00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 1,034 | $27K |
| 2020 | 5,615 | $145K |
| 2021 | 4,737 | $135K |
| 2022 | 5,274 | $156K |
| 2023 | 6,225 | $188K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 4,357 | 4,295 | $174K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 5,647 | 2,890 | $173K |
| V2020 | Vision svcs frames purchases | 5,963 | 5,222 | $123K |
| 92004 | 2,474 | 2,439 | $99K | |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 744 | 445 | $31K |
| V2100 | Lens spher single plano 4.00 | 588 | 459 | $25K |
| S0500 | Dispos cont lens | 241 | 239 | $16K |
| S0581 | Nonstnd lens | 71 | 41 | $3K |
| V2750 | Anti-reflective coating | 2,466 | 1,311 | $2K |
| V2107 | Spherocylinder 4.25d/12-2d | 73 | 42 | $2K |
| V2744 | Tint photochromatic lens/es | 240 | 131 | $622.50 |
| V2104 | Spherocylindr 4.00d/2.12-4d | 21 | 15 | $594.22 |