NPI: 1790858165 · PASSAIC, NJ 07055 · 207W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 2,508 | $834.50 |
| 2019 | 1,925 | $567.20 |
| 2020 | 1,224 | $0.00 |
| 2021 | 936 | $0.00 |
| 2022 | 888 | $0.00 |
| 2023 | 866 | $0.00 |
| 2024 | 559 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2784 | Lens polycarb or equal | 1,697 | 1,635 | $840.00 |
| V2020 | Vision svcs frames purchases | 3,709 | 3,670 | $336.00 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 1,404 | 1,369 | $144.50 |
| V2100 | Lens spher single plano 4.00 | 243 | 241 | $81.20 |
| S0621 | Routine ophthalmological exa | 1,141 | 1,138 | $0.00 |
| V2303 | Lens sphcy trifocal 4.0/.12- | 283 | 279 | $0.00 |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 39 | 39 | $0.00 |
| S0620 | Routine ophthalmological exa | 390 | 390 | $0.00 |