NPI: 1114591815 · MANCHESTER, CT 06042 · 156FX1800X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 1,128 | $29K |
| 2022 | 1,673 | $42K |
| 2023 | 1,582 | $41K |
| 2024 | 1,598 | $41K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 1,956 | 1,891 | $56K |
| 92340 | 1,627 | 1,559 | $33K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 1,035 | 1,004 | $29K |
| S0580 | Polycarb lens | 832 | 798 | $24K |
| 92341 | 228 | 221 | $5K | |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 96 | 93 | $4K |
| V2100 | Lens spher single plano 4.00 | 139 | 134 | $3K |
| V2730 | Special base curve | 68 | 66 | $940.76 |