NPI: 1184118747 · HARRISBURG, PA 17110 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 50 | $2K |
| 2021 | 980 | $28K |
| 2022 | 1,963 | $59K |
| 2023 | 1,550 | $53K |
| 2024 | 669 | $25K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 1,549 | 1,515 | $85K |
| S0620 | Routine ophthalmological exa | 934 | 909 | $28K |
| V2100 | Lens spher single plano 4.00 | 688 | 676 | $19K |
| 92014 | 374 | 369 | $14K | |
| 92004 | 154 | 151 | $6K | |
| V2784 | Lens polycarb or equal | 394 | 390 | $6K |
| S0621 | Routine ophthalmological exa | 189 | 185 | $6K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 65 | 63 | $2K |
| 92340 | 168 | 129 | $1K | |
| 92015 | 684 | 663 | $882.00 | |
| V2750 | Anti-reflective coating | 13 | 13 | $44.24 |