NPI: 1700174497 · WEST CHESTER, PA 19382 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 38 | $3K |
| 2022 | 607 | $4K |
| 2023 | 26 | $1K |
| 2024 | 17 | $199.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 187 | 187 | $7K |
| 92004 | 165 | 84 | $455.00 | |
| V2100 | Lens spher single plano 4.00 | 74 | 74 | $399.08 |
| S0621 | Routine ophthalmological exa | 12 | 12 | $360.00 |
| 92014 | 40 | 20 | $130.00 | |
| V2784 | Lens polycarb or equal | 74 | 74 | $64.00 |
| V2750 | Anti-reflective coating | 36 | 36 | $0.00 |
| 92015 | 100 | 70 | $0.00 |