NPI: 1558853606 · MERRIMACK, NH 03054 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 1,188 | $15K |
| 2020 | 44 | $878.07 |
| 2021 | 741 | $19K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 227 | 204 | $12K | |
| 92015 | 462 | 398 | $7K | |
| 92014 | 139 | 120 | $5K | |
| V2020 | Vision svcs frames purchases | 348 | 300 | $4K |
| 92340 | 223 | 197 | $4K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 169 | 149 | $2K |
| V2784 | Lens polycarb or equal | 227 | 196 | $1K |
| V2025 | Eyeglasses delux frames | 12 | 12 | $0.00 |
| V2750 | Anti-reflective coating | 46 | 43 | $0.00 |
| V2755 | Uv lens/es | 120 | 105 | $0.00 |