NPI: 1528054285 · JOHNSONBURG, PA 15845 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 116 | $5K |
| 2021 | 936 | $38K |
| 2022 | 1,127 | $46K |
| 2023 | 1,140 | $49K |
| 2024 | 576 | $25K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2784 | Lens polycarb or equal | 1,111 | 1,091 | $62K |
| V2020 | Vision svcs frames purchases | 1,350 | 1,331 | $56K |
| S0621 | Routine ophthalmological exa | 1,377 | 1,364 | $41K |
| S0500 | Dispos cont lens | 13 | 13 | $850.00 |
| 92250 | 12 | 12 | $619.55 | |
| S0592 | Comp cont lens eval | 16 | 16 | $549.00 |
| 92015 | 16 | 16 | $19.80 |