NPI: 1699781351 · BRENTWOOD, NY 11717 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,718 | $20K |
| 2019 | 525 | $4K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 190 | 189 | $8K | |
| 92014 | 148 | 148 | $5K | |
| 92340 | 295 | 295 | $4K | |
| V2020 | Vision svcs frames purchases | 433 | 431 | $2K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 250 | 125 | $2K |
| 92015 | 199 | 198 | $2K | |
| V2100 | Lens spher single plano 4.00 | 60 | 30 | $698.36 |
| V2784 | Lens polycarb or equal | 668 | 334 | $0.00 |