NPI: 1851380299 · PLATTSBURGH, NY 12901 · 174400000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,623 | $22K |
| 2019 | 772 | $10K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 202 | 202 | $8K | |
| 92004 | 185 | 185 | $7K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 316 | 158 | $6K |
| V2020 | Vision svcs frames purchases | 443 | 442 | $5K |
| S0621 | Routine ophthalmological exa | 49 | 48 | $2K |
| V2100 | Lens spher single plano 4.00 | 80 | 40 | $2K |
| S0620 | Routine ophthalmological exa | 30 | 30 | $1K |
| 99214 | 13 | 13 | $505.62 | |
| 99213 | 12 | 12 | $448.92 | |
| 92012 | 13 | 13 | $215.11 | |
| V2784 | Lens polycarb or equal | 1,052 | 525 | $0.00 |