NPI: 1366418543 · PASSAIC, NJ 07055 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 4,539 | $1K |
| 2019 | 3,347 | $165.45 |
| 2020 | 2,333 | $0.00 |
| 2021 | 107 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 1,868 | 1,858 | $927.15 | |
| 92012 | 29 | 24 | $440.00 | |
| 92004 | 1,298 | 1,294 | $132.00 | |
| 92250 | 12 | 12 | $56.76 | |
| V2020 | Vision svcs frames purchases | 2,540 | 2,516 | $0.00 |
| 92015 | 1,000 | 999 | $0.00 | |
| V2750 | Anti-reflective coating | 62 | 62 | $0.00 |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 40 | 39 | $0.00 |
| V2784 | Lens polycarb or equal | 1,324 | 1,315 | $0.00 |
| V2100 | Lens spher single plano 4.00 | 1,333 | 1,323 | $0.00 |
| V2104 | Spherocylindr 4.00d/2.12-4d | 135 | 135 | $0.00 |
| V2200 | Lens spher bifoc plano 4.00d | 244 | 244 | $0.00 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 402 | 397 | $0.00 |
| 92310 | 39 | 39 | $0.00 |