NPI: 1558402974 · JEFFERSON VALLEY, NY 10535 · 156FX1800X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 305 | $16K |
| 2019 | 1,161 | $107K |
| 2020 | 846 | $71K |
| 2021 | 1,368 | $127K |
| 2022 | 2,158 | $182K |
| 2023 | 2,403 | $201K |
| 2024 | 2,101 | $167K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 6,636 | 6,614 | $394K |
| 92004 | 2,163 | 2,163 | $320K | |
| 92018 | 900 | 898 | $124K | |
| V2020 | Vision svcs frames purchases | 501 | 497 | $21K |
| 99215 | Prolong outpt/office vis | 40 | 39 | $6K |
| V2200 | Lens spher bifoc plano 4.00d | 90 | 90 | $5K |
| V2784 | Lens polycarb or equal | 12 | 12 | $0.00 |