NPI: 1659524767 · STROUDSBURG, PA 18360 · 156FX1800X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 54 | $2K |
| 2020 | 1,993 | $42K |
| 2021 | 4,335 | $84K |
| 2022 | 3,477 | $74K |
| 2023 | 3,541 | $70K |
| 2024 | 2,590 | $58K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 5,721 | 2,344 | $154K |
| V2020 | Vision svcs frames purchases | 2,988 | 2,490 | $54K |
| 92014 | 1,110 | 1,098 | $44K | |
| 92004 | 769 | 763 | $31K | |
| 92012 | 676 | 625 | $26K | |
| 92002 | 397 | 358 | $16K | |
| V2784 | Lens polycarb or equal | 3,300 | 1,434 | $3K |
| V2299 | Lens bifocal speciality | 28 | 14 | $1K |
| 92250 | 12 | 12 | $638.04 | |
| V2750 | Anti-reflective coating | 835 | 405 | $69.00 |
| V2744 | Tint photochromatic lens/es | 126 | 60 | $0.00 |
| V2781 | Progressive lens per lens | 28 | 14 | $0.00 |