NPI: 1295038552 · JERSEY CITY, NJ 07307 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 26 | $937.80 |
| 2023 | 1,370 | $19K |
| 2024 | 1,496 | $21K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 468 | 466 | $22K | |
| V2020 | Vision svcs frames purchases | 439 | 437 | $6K |
| 92250 | 225 | 212 | $5K | |
| V2100 | Lens spher single plano 4.00 | 337 | 330 | $5K |
| 92015 | 455 | 447 | $1K | |
| 92340 | 403 | 393 | $720.00 | |
| V2784 | Lens polycarb or equal | 103 | 103 | $399.00 |
| 2026F | 252 | 235 | $0.00 | |
| 3072F | 210 | 209 | $0.00 |