NPI: 1275527467 · LANCASTER, OH 43130 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 4,156 | $81K |
| 2021 | 902 | $17K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 1,122 | 1,105 | $27K |
| V2020 | Vision svcs frames purchases | 1,382 | 1,364 | $24K |
| 92014 | 447 | 443 | $19K | |
| 92004 | 275 | 273 | $12K | |
| V2784 | Lens polycarb or equal | 813 | 798 | $11K |
| V2200 | Lens spher bifoc plano 4.00d | 138 | 138 | $5K |
| 92015 | 731 | 725 | $0.00 | |
| 99072 | 132 | 126 | $0.00 | |
| V2750 | Anti-reflective coating | 18 | 17 | $0.00 |