NPI: 1275649592 · SCRANTON, PA 18503 · 332H00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 56 | $4K |
| 2019 | 126 | $6K |
| 2020 | 2,975 | $97K |
| 2021 | 22,562 | $718K |
| 2022 | 2,263 | $58K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2784 | Lens polycarb or equal | 9,175 | 8,510 | $458K |
| V2020 | Vision svcs frames purchases | 10,856 | 9,558 | $163K |
| V2100 | Lens spher single plano 4.00 | 3,887 | 2,778 | $128K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 3,395 | 3,358 | $104K |
| V2200 | Lens spher bifoc plano 4.00d | 473 | 301 | $23K |
| V2750 | Anti-reflective coating | 101 | 96 | $4K |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 48 | 44 | $2K |
| V2744 | Tint photochromatic lens/es | 47 | 42 | $774.00 |