NPI: 1811419740 · ERIE, PA 16506 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 496 | $8K |
| 2021 | 3,373 | $82K |
| 2022 | 3,298 | $91K |
| 2023 | 3,942 | $115K |
| 2024 | 1,504 | $44K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Vision svcs frames purchases | 1,769 | 1,641 | $103K |
| V2025 | Eyeglasses delux frames | 998 | 786 | $94K |
| S0621 | Routine ophthalmological exa | 2,120 | 1,895 | $63K |
| S0620 | Routine ophthalmological exa | 1,054 | 1,012 | $32K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 842 | 758 | $23K |
| V2100 | Lens spher single plano 4.00 | 317 | 302 | $9K |
| 92014 | 207 | 205 | $7K | |
| 92004 | 76 | 76 | $3K | |
| 92310 | 108 | 66 | $2K | |
| V2784 | Lens polycarb or equal | 151 | 151 | $2K |
| S0592 | Comp cont lens eval | 30 | 30 | $1K |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 15 | 13 | $438.00 |
| 99213 | 12 | 12 | $385.00 | |
| 92015 | 3,641 | 3,357 | $14.85 | |
| V2799 | Misc vision item or service | 1,273 | 825 | $0.00 |