NPI: 1194229708 · UPPER DARBY, PA 19082 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 207 | $4K |
| 2020 | 941 | $21K |
| 2021 | 3,632 | $79K |
| 2022 | 6,282 | $153K |
| 2023 | 7,931 | $193K |
| 2024 | 167 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 4,801 | 1,652 | $129K |
| 92004 | 2,025 | 1,961 | $83K | |
| V2020 | Vision svcs frames purchases | 2,616 | 1,819 | $78K |
| 92014 | 1,332 | 1,300 | $54K | |
| V2750 | Anti-reflective coating | 1,768 | 739 | $33K |
| 92250 | 632 | 616 | $33K | |
| 99214 | 596 | 560 | $26K | |
| V2784 | Lens polycarb or equal | 4,838 | 1,658 | $11K |
| 92083 | 61 | 54 | $4K | |
| 99213 | 43 | 43 | $2K | |
| 92133 | 31 | 28 | $1K | |
| 92020 | 13 | 12 | $227.00 | |
| 92015 | 331 | 303 | $40.00 | |
| 2022F | 73 | 58 | $0.00 |