NPI: 1114206547 · LONDONDERRY, NH 03038 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 2,949 | $63K |
| 2019 | 4,063 | $98K |
| 2020 | 3,096 | $72K |
| 2021 | 4,262 | $91K |
| 2022 | 591 | $15K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 2,070 | 1,792 | $102K | |
| 92015 | 3,282 | 2,885 | $60K | |
| V2020 | Vision svcs frames purchases | 2,566 | 2,222 | $53K |
| 92340 | 1,937 | 1,736 | $49K | |
| 92004 | 603 | 555 | $42K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 973 | 755 | $13K |
| V2784 | Lens polycarb or equal | 2,521 | 2,207 | $11K |
| V2100 | Lens spher single plano 4.00 | 965 | 636 | $7K |
| 99213 | 31 | 25 | $1K | |
| 99214 | 13 | 12 | $677.90 |