NPI: 1184635286 · WELLSBORO, PA 16901 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 323 | $1K |
| 2019 | 955 | $24K |
| 2020 | 709 | $22K |
| 2021 | 6,326 | $176K |
| 2022 | 6,337 | $180K |
| 2023 | 6,195 | $168K |
| 2024 | 4,657 | $112K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 5,745 | 2,804 | $156K |
| V2020 | Vision svcs frames purchases | 3,836 | 3,522 | $153K |
| 92012 | 3,396 | 3,327 | $126K | |
| 92002 | 1,952 | 1,920 | $76K | |
| 99214 | 1,132 | 1,127 | $47K | |
| 92134 | 1,162 | 1,153 | $31K | |
| 99213 | 798 | 700 | $22K | |
| 92083 | 381 | 380 | $21K | |
| V2784 | Lens polycarb or equal | 4,286 | 1,985 | $16K |
| 92015 | 1,578 | 1,564 | $8K | |
| V2200 | Lens spher bifoc plano 4.00d | 187 | 101 | $7K |
| V2744 | Tint photochromatic lens/es | 228 | 113 | $7K |
| V2750 | Anti-reflective coating | 232 | 115 | $4K |
| 92014 | 235 | 234 | $4K | |
| V2781 | Progressive lens per lens | 58 | 29 | $2K |
| V2299 | Lens bifocal speciality | 58 | 29 | $2K |
| 92004 | 38 | 38 | $2K | |
| 99204 | 12 | 12 | $894.66 | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 30 | 14 | $802.20 |
| V2760 | Scratch resistant coating | 50 | 24 | $445.00 |
| 2022F | 12 | 12 | $0.00 | |
| G8731 | Pain neg no plan | 35 | 35 | $0.00 |
| G8427 | Docrev cur meds by elig clin | 32 | 32 | $0.00 |
| 1036F | 29 | 29 | $0.00 |