NPI: 1750350807 · ROCHESTER, PA 15074 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 252 | $11K |
| 2021 | 1,640 | $70K |
| 2022 | 1,579 | $69K |
| 2023 | 1,639 | $71K |
| 2024 | 1,740 | $76K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | 1,727 | 1,648 | $97K |
| V2020 | Vision svcs frames purchases | 2,183 | 2,152 | $95K |
| S0621 | Routine ophthalmological exa | 1,117 | 1,108 | $34K |
| 92012 | 776 | 773 | $31K | |
| V2200 | Lens spher bifoc plano 4.00d | 527 | 508 | $28K |
| S0620 | Routine ophthalmological exa | 140 | 140 | $4K |
| V2025 | Eyeglasses delux frames | 182 | 175 | $2K |
| 92002 | 48 | 45 | $2K | |
| 92015 | 84 | 83 | $2K | |
| V2784 | Lens polycarb or equal | 66 | 61 | $1K |