NPI: 1699132142 · PHILADELPHIA, PA 19133 · 156FX1800X
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 532 | $12K |
| 2020 | 1,966 | $46K |
| 2021 | 7,326 | $182K |
| 2022 | 9,242 | $251K |
| 2023 | 8,910 | $245K |
| 2024 | 8,932 | $253K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 7,369 | 4,922 | $318K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 6,722 | 2,265 | $185K |
| 92012 | 4,184 | 4,128 | $179K | |
| V2100 | Lens spher single plano 4.00 | 5,297 | 1,842 | $146K |
| 92002 | 2,208 | 2,147 | $92K | |
| 92250 | 272 | 270 | $14K | |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 347 | 198 | $12K |
| 92004 | 243 | 243 | $11K | |
| V2744 | Tint photochromatic lens/es | 306 | 143 | $10K |
| V2200 | Lens spher bifoc plano 4.00d | 126 | 64 | $5K |
| V2299 | Lens bifocal speciality | 100 | 50 | $4K |
| 92340 | 359 | 340 | $4K | |
| V2781 | Progressive lens per lens | 100 | 50 | $3K |
| V2750 | Anti-reflective coating | 90 | 40 | $2K |
| V2784 | Lens polycarb or equal | 8,711 | 2,379 | $2K |
| 92015 | 272 | 257 | $2K | |
| 92014 | 30 | 28 | $1K | |
| S0621 | Routine ophthalmological exa | 13 | 13 | $390.00 |
| 2022F | 159 | 157 | $0.00 |