NPI: 1851366876 · MERRIMACK, NH 03054 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 3,344 | $94K |
| 2019 | 3,363 | $92K |
| 2020 | 405 | $8K |
| 2021 | 2,347 | $64K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 795 | 669 | $58K | |
| V2020 | Vision svcs frames purchases | 1,730 | 1,426 | $49K |
| 92014 | 775 | 670 | $46K | |
| 92015 | 1,745 | 1,504 | $37K | |
| 92340 | 1,291 | 1,079 | $32K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 999 | 822 | $18K |
| V2784 | Lens polycarb or equal | 1,670 | 1,390 | $9K |
| 00000 | 90 | 20 | $2K | |
| V2100 | Lens spher single plano 4.00 | 198 | 169 | $2K |
| 92012 | 33 | 28 | $1K | |
| 92250 | 57 | 53 | $860.56 | |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | 29 | 26 | $741.00 |
| 99213 | 14 | 14 | $598.08 | |
| 92341 | 15 | 12 | $487.50 | |
| V2750 | Anti-reflective coating | 18 | 13 | $381.50 |