NPI: 1508803917 · HARRISBURG, PA 17111 · 332H00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 565 | $21K |
| 2021 | 2,216 | $73K |
| 2022 | 2,671 | $91K |
| 2023 | 1,894 | $64K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 1,586 | 1,577 | $64K | |
| 92014 | 1,359 | 1,347 | $54K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 1,125 | 823 | $51K |
| V2020 | Vision svcs frames purchases | 2,408 | 2,268 | $40K |
| V2100 | Lens spher single plano 4.00 | 432 | 402 | $25K |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 116 | 92 | $6K |
| V2200 | Lens spher bifoc plano 4.00d | 45 | 45 | $3K |
| S0500 | Dispos cont lens | 37 | 37 | $3K |
| V2599 | Contact lens/es other type | 15 | 15 | $1K |
| V2784 | Lens polycarb or equal | 29 | 12 | $500.16 |
| V2750 | Anti-reflective coating | 162 | 117 | $167.00 |
| V2744 | Tint photochromatic lens/es | 32 | 24 | $15.00 |