NPI: 1720061021 · LANCASTER, PA 17603 · 152WC0802X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 1,855 | $63K |
| 2021 | 3,616 | $135K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 1,280 | 532 | $44K |
| V2020 | Vision svcs frames purchases | 799 | 584 | $40K |
| 92250 | 567 | 563 | $31K | |
| 92083 | 353 | 350 | $23K | |
| 92014 | 549 | 511 | $23K | |
| V2200 | Lens spher bifoc plano 4.00d | 213 | 131 | $11K |
| 92012 | 235 | 235 | $9K | |
| 92004 | 205 | 202 | $9K | |
| V2025 | Eyeglasses delux frames | 222 | 214 | $3K |
| 99213 | 62 | 61 | $2K | |
| 92133 | 26 | 26 | $944.79 | |
| 92015 | 176 | 176 | $625.50 | |
| 92340 | 56 | 56 | $560.00 | |
| V2784 | Lens polycarb or equal | 701 | 212 | $472.00 |
| 99212 | 13 | 13 | $360.00 | |
| 92285 | 14 | 14 | $176.87 |