NPI: 1285288506 · HAGERSTOWN, MD 21740 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 17 | $707.15 |
| 2021 | 1,392 | $27K |
| 2022 | 4,460 | $61K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 1,677 | 1,448 | $44K | |
| V2100 | Lens spher single plano 4.00 | 805 | 714 | $14K |
| V2020 | Vision svcs frames purchases | 992 | 887 | $14K |
| 92004 | 233 | 216 | $7K | |
| V2781 | Progressive lens per lens | 94 | 75 | $3K |
| V2784 | Lens polycarb or equal | 646 | 572 | $3K |
| V2299 | Lens bifocal speciality | 94 | 75 | $2K |
| 92310 | 28 | 25 | $792.00 | |
| V2200 | Lens spher bifoc plano 4.00d | 19 | 18 | $490.10 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 12 | 12 | $248.80 |
| V2750 | Anti-reflective coating | 315 | 268 | $0.00 |
| 92015 | 954 | 831 | $0.00 |