NPI: 1245337492 · ROCKVILLE, MD 20850 · 207W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 3,008 | $117K |
| 2021 | 1,812 | $42K |
| 2022 | 4,422 | $51K |
| 2023 | 3,888 | $47K |
| 2024 | 4,750 | $58K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 5,448 | 5,318 | $76K |
| 99214 | 344 | 342 | $42K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 2,355 | 2,292 | $37K |
| V2784 | Lens polycarb or equal | 5,775 | 5,618 | $35K |
| V2104 | Spherocylindr 4.00d/2.12-4d | 1,845 | 1,807 | $31K |
| 99204 | 149 | 149 | $27K | |
| 99213 | 198 | 196 | $17K | |
| 92015 | 729 | 728 | $16K | |
| 92060 | 221 | 220 | $16K | |
| V2100 | Lens spher single plano 4.00 | 651 | 622 | $10K |
| 99203 | 42 | 42 | $5K | |
| V2105 | Spherocylinder 4.00d/4.25-6d | 80 | 74 | $1K |
| V2107 | Spherocylinder 4.25d/12-2d | 26 | 26 | $398.08 |
| V2750 | Anti-reflective coating | 17 | 17 | $0.00 |