NPI: 1063819001 · WILKES BARRE, PA 18702 · 332H00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 535 | $14K |
| 2021 | 1,799 | $44K |
| 2022 | 1,588 | $36K |
| 2023 | 2,177 | $47K |
| 2024 | 2,007 | $44K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 3,363 | 1,406 | $92K |
| V2020 | Vision svcs frames purchases | 1,903 | 1,588 | $37K |
| 92014 | 676 | 640 | $27K | |
| 92004 | 584 | 558 | $24K | |
| V2784 | Lens polycarb or equal | 1,378 | 636 | $5K |
| V2750 | Anti-reflective coating | 178 | 81 | $149.00 |
| V2755 | Uv lens/es | 24 | 12 | $96.00 |