NPI: 1154493039 · BERWYN, IL 60402 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 413 | $17K |
| 2021 | 788 | $33K |
| 2022 | 1,679 | $43K |
| 2023 | 2,234 | $51K |
| 2024 | 386 | $8K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 983 | 947 | $36K |
| V2020 | Vision svcs frames purchases | 1,042 | 999 | $28K |
| 92004 | 625 | 590 | $26K | |
| 92012 | 380 | 375 | $17K | |
| 92014 | 405 | 403 | $17K | |
| 92340 | 513 | 485 | $11K | |
| 92015 | 864 | 853 | $10K | |
| V2784 | Lens polycarb or equal | 593 | 558 | $7K |
| S0621 | Routine ophthalmological exa | 15 | 15 | $666.75 |
| V2025 | Eyeglasses delux frames | 16 | 16 | $640.00 |
| 92250 | 64 | 64 | $0.00 |