NPI: 1104113752 · YORK, PA 17404 · 332H00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 1,294 | $34K |
| 2021 | 10,419 | $251K |
| 2022 | 5,756 | $151K |
| 2023 | 4,168 | $128K |
| 2024 | 5,039 | $150K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 9,886 | 6,196 | $294K |
| V2020 | Vision svcs frames purchases | 8,844 | 7,213 | $245K |
| 92014 | 1,311 | 1,256 | $55K | |
| 92340 | 2,345 | 1,793 | $52K | |
| 92004 | 598 | 574 | $25K | |
| V2784 | Lens polycarb or equal | 2,696 | 1,293 | $20K |
| V2200 | Lens spher bifoc plano 4.00d | 521 | 360 | $14K |
| 92012 | 169 | 169 | $7K | |
| 92341 | 177 | 135 | $4K | |
| V2750 | Anti-reflective coating | 59 | 41 | $497.49 |
| V2755 | Uv lens/es | 49 | 15 | $236.00 |
| V2799 | Misc vision item or service | 21 | 12 | $0.00 |