NPI: 1063594323 · UTICA, NY 13501 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 9,840 | $154K |
| 2019 | 2,160 | $33K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 1,097 | 1,083 | $49K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 2,126 | 1,059 | $44K |
| 92004 | 582 | 572 | $27K | |
| V2020 | Vision svcs frames purchases | 2,241 | 2,224 | $24K |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 482 | 238 | $14K |
| V2100 | Lens spher single plano 4.00 | 806 | 495 | $13K |
| 92250 | 213 | 197 | $8K | |
| S0621 | Routine ophthalmological exa | 157 | 157 | $6K |
| S0620 | Routine ophthalmological exa | 55 | 55 | $2K |
| V2104 | Spherocylindr 4.00d/2.12-4d | 32 | 15 | $657.28 |
| V2200 | Lens spher bifoc plano 4.00d | 19 | 13 | $342.96 |
| V2784 | Lens polycarb or equal | 4,190 | 2,117 | $0.00 |