NPI: 1164938346 · WEST ORANGE, NJ 07052 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 578 | $5K |
| 2022 | 568 | $4K |
| 2023 | 898 | $6K |
| 2024 | 733 | $5K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 850 | 845 | $13K | |
| V2020 | Vision svcs frames purchases | 739 | 734 | $4K |
| V2100 | Lens spher single plano 4.00 | 719 | 411 | $2K |
| V2784 | Lens polycarb or equal | 195 | 111 | $969.38 |
| 92015 | 154 | 152 | $410.20 | |
| 92014 | 26 | 26 | $326.40 | |
| 92250 | 12 | 12 | $240.00 | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 39 | 24 | $126.00 |
| V2750 | Anti-reflective coating | 30 | 15 | $0.00 |
| 3072F | 13 | 13 | $0.00 |