NPI: 1720178577 · WILLIMANTIC, CT 06226 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 4,313 | $126K |
| 2019 | 4,395 | $122K |
| 2020 | 901 | $27K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92015 | 1,945 | 1,575 | $56K | |
| 92014 | 1,384 | 1,171 | $45K | |
| V2020 | Vision svcs frames purchases | 1,426 | 1,379 | $41K |
| 92004 | 625 | 516 | $31K | |
| S0580 | Polycarb lens | 799 | 762 | $22K |
| 92340 | 1,038 | 996 | $22K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 492 | 477 | $17K |
| V2204 | Lens sphcy bifocal 4.00d/2.1 | 330 | 313 | $16K |
| 99213 | 470 | 379 | $9K | |
| 92341 | 382 | 364 | $9K | |
| V2100 | Lens spher single plano 4.00 | 200 | 184 | $6K |
| 92133 | 97 | 79 | $1K | |
| 92083 | 52 | 50 | $1K | |
| 92370 | 24 | 24 | $339.53 | |
| G8427 | Docrev cur meds by elig clin | 265 | 263 | $0.00 |
| 1036F | 66 | 66 | $0.00 | |
| G9903 | Pt scrn tbco id as non user | 14 | 14 | $0.00 |