NPI: 1730292871 · MECHANICSBURG, PA 17050 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 266 | $11K |
| 2021 | 1,567 | $49K |
| 2022 | 1,118 | $38K |
| 2023 | 213 | $6K |
| 2024 | 187 | $6K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 1,027 | 1,021 | $63K |
| S0621 | Routine ophthalmological exa | 556 | 553 | $17K |
| 92014 | 320 | 319 | $11K | |
| S0620 | Routine ophthalmological exa | 313 | 313 | $9K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 448 | 446 | $6K |
| V2784 | Lens polycarb or equal | 119 | 118 | $1K |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 82 | 81 | $625.50 |
| V2100 | Lens spher single plano 4.00 | 13 | 13 | $251.80 |
| V2750 | Anti-reflective coating | 26 | 26 | $9.24 |
| 92250 | 13 | 13 | $0.00 | |
| 92015 | 434 | 433 | $0.00 |