NPI: 1174182588 · PHILADELPHIA, PA 19124 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 2,681 | $63K |
| 2021 | 11,536 | $291K |
| 2022 | 16,237 | $440K |
| 2023 | 16,947 | $459K |
| 2024 | 17,464 | $476K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 19,910 | 8,315 | $548K |
| V2020 | Vision svcs frames purchases | 10,826 | 9,104 | $462K |
| 92004 | 7,090 | 6,966 | $319K | |
| 92014 | 4,529 | 4,447 | $200K | |
| 92250 | 1,356 | 1,335 | $71K | |
| V2750 | Anti-reflective coating | 1,462 | 586 | $32K |
| V2784 | Lens polycarb or equal | 16,760 | 6,696 | $26K |
| 99213 | 685 | 614 | $24K | |
| 99204 | 149 | 149 | $11K | |
| V2520 | Contact lens hydrophilic | 90 | 81 | $9K |
| 99214 | 105 | 105 | $5K | |
| V2781 | Progressive lens per lens | 119 | 61 | $5K |
| 92340 | 487 | 477 | $5K | |
| V2299 | Lens bifocal speciality | 116 | 58 | $4K |
| 92015 | 829 | 807 | $4K | |
| V2200 | Lens spher bifoc plano 4.00d | 75 | 39 | $3K |
| V2744 | Tint photochromatic lens/es | 48 | 24 | $2K |
| 2025F | 196 | 192 | $30.00 | |
| 2023F | 33 | 27 | $0.00 |