NPI: 1104478445 · HAGERSTOWN, MD 21740 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 681 | $13K |
| 2021 | 6,894 | $108K |
| 2022 | 5,377 | $70K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 2,142 | 1,806 | $52K | |
| V2100 | Lens spher single plano 4.00 | 2,122 | 1,986 | $40K |
| V2020 | Vision svcs frames purchases | 2,563 | 2,411 | $38K |
| 92004 | 1,205 | 1,003 | $28K | |
| V2781 | Progressive lens per lens | 279 | 257 | $12K |
| V2784 | Lens polycarb or equal | 1,485 | 1,385 | $11K |
| V2299 | Lens bifocal speciality | 280 | 258 | $8K |
| V2200 | Lens spher bifoc plano 4.00d | 82 | 80 | $3K |
| V2744 | Tint photochromatic lens/es | 18 | 18 | $0.00 |
| V2750 | Anti-reflective coating | 633 | 587 | $0.00 |
| 92015 | 2,143 | 1,986 | $0.00 |