NPI: 1790792695 · DUBOIS, PA 15801 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 582 | $18K |
| 2021 | 3,177 | $99K |
| 2022 | 2,413 | $75K |
| 2023 | 2,942 | $92K |
| 2024 | 1,071 | $34K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 2,392 | 2,303 | $85K |
| S0621 | Routine ophthalmological exa | 2,693 | 2,636 | $80K |
| V2100 | Lens spher single plano 4.00 | 2,058 | 1,976 | $69K |
| V2784 | Lens polycarb or equal | 1,126 | 1,110 | $34K |
| 92014 | 387 | 386 | $14K | |
| V2760 | Scratch resistant coating | 891 | 859 | $12K |
| S0620 | Routine ophthalmological exa | 361 | 356 | $11K |
| V2200 | Lens spher bifoc plano 4.00d | 175 | 174 | $8K |
| S0500 | Dispos cont lens | 43 | 43 | $3K |
| 92250 | 34 | 34 | $2K | |
| V2744 | Tint photochromatic lens/es | 13 | 12 | $438.00 |
| 92133 | 12 | 12 | $334.70 |