NPI: 1487183919 · WINDSOR, VT 05089 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 1,219 | $20K |
| 2021 | 3,413 | $55K |
| 2022 | 3,037 | $66K |
| 2023 | 1,184 | $26K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 1,586 | 1,569 | $65K | |
| V2020 | Vision svcs frames purchases | 1,812 | 1,729 | $29K |
| V2100 | Lens spher single plano 4.00 | 948 | 901 | $22K |
| 92340 | 1,098 | 1,074 | $15K | |
| 92015 | 1,506 | 1,493 | $15K | |
| V2784 | Lens polycarb or equal | 1,379 | 1,122 | $12K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 345 | 247 | $4K |
| 92341 | 104 | 98 | $1K | |
| 92004 | 31 | 31 | $1K | |
| V2200 | Lens spher bifoc plano 4.00d | 28 | 28 | $992.63 |
| V2799 | Misc vision item or service | 16 | 14 | $0.00 |