NPI: 1710176763 · GAITHERSBURG, MD 20879 · 174400000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 4,262 | $36K |
| 2021 | 4,578 | $36K |
| 2022 | 2,727 | $32K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 4,493 | 2,561 | $43K |
| V2020 | Vision svcs frames purchases | 3,910 | 2,847 | $37K |
| V2784 | Lens polycarb or equal | 2,847 | 1,995 | $19K |
| 92340 | 122 | 114 | $3K | |
| V2200 | Lens spher bifoc plano 4.00d | 166 | 66 | $1K |
| V2750 | Anti-reflective coating | 29 | 29 | $0.00 |