NPI: 1427798651 · UPPER DARBY, PA 19082 · 332H00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 558 | $7K |
| 2023 | 8,973 | $178K |
| 2024 | 9,001 | $187K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 5,430 | 1,606 | $147K |
| V2020 | Vision svcs frames purchases | 3,371 | 2,096 | $109K |
| 92012 | 1,614 | 1,593 | $63K | |
| 92002 | 715 | 714 | $27K | |
| 92340 | 863 | 857 | $9K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 202 | 81 | $5K |
| 92014 | 113 | 113 | $5K | |
| 92015 | 702 | 699 | $4K | |
| V2784 | Lens polycarb or equal | 5,502 | 1,623 | $2K |
| 92004 | 20 | 20 | $819.05 |