NPI: 1003862962 · WOONSOCKET, RI 02895 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,232 | $36K |
| 2019 | 32 | $748.04 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99214 | 155 | 150 | $10K | |
| 92015 | 341 | 304 | $7K | |
| V2020 | Vision svcs frames purchases | 313 | 301 | $6K |
| 92340 | 230 | 218 | $4K | |
| 99204 | 36 | 30 | $4K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 89 | 85 | $3K |
| S0580 | Polycarb lens | 68 | 66 | $1K |
| V2100 | Lens spher single plano 4.00 | 17 | 13 | $573.00 |
| 92341 | 15 | 14 | $295.08 |