NPI: 1669520292 · ROBBINSVILLE, NJ 08691 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 956 | $826.80 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 97 | 97 | $551.00 | |
| 92004 | 130 | 130 | $161.80 | |
| V2020 | Vision svcs frames purchases | 280 | 280 | $60.00 |
| 92015 | 12 | 12 | $33.00 | |
| V2100 | Lens spher single plano 4.00 | 22 | 12 | $21.00 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 169 | 104 | $0.00 |
| V2784 | Lens polycarb or equal | 196 | 114 | $0.00 |
| S0620 | Routine ophthalmological exa | 35 | 35 | $0.00 |
| S0621 | Routine ophthalmological exa | 15 | 15 | $0.00 |