NPI: 1760092977 · MIDDLETOWN, NY 10940 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 29 | $752.50 |
| 2021 | 1,410 | $31K |
| 2022 | 5,378 | $138K |
| 2023 | 4,705 | $128K |
| 2024 | 2,175 | $84K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 1,407 | 1,394 | $92K | |
| 92250 | 1,423 | 1,418 | $62K | |
| V2100 | Lens spher single plano 4.00 | 2,341 | 1,214 | $46K |
| V2020 | Vision svcs frames purchases | 2,597 | 2,575 | $31K |
| 92285 | 1,161 | 1,126 | $31K | |
| 76512 | 394 | 222 | $26K | |
| 92083 | 396 | 395 | $19K | |
| 92002 | 428 | 428 | $13K | |
| 92340 | 907 | 907 | $13K | |
| 92060 | 265 | 264 | $12K | |
| V2784 | Lens polycarb or equal | 1,128 | 706 | $7K |
| V2200 | Lens spher bifoc plano 4.00d | 238 | 123 | $7K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 434 | 401 | $5K |
| 92012 | 137 | 137 | $4K | |
| 92082 | 101 | 101 | $4K | |
| 92015 | 130 | 130 | $2K | |
| 92341 | 120 | 120 | $2K | |
| 92014 | 34 | 34 | $2K | |
| 92286 | 15 | 15 | $528.66 | |
| V2104 | Spherocylindr 4.00d/2.12-4d | 14 | 14 | $166.64 |
| 76514 | 15 | 15 | $157.85 | |
| 92020 | 12 | 12 | $54.60 |