NPI: 1922147453 · LISBON, CT 06351 · 152WC0802X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 3,462 | $59K |
| 2019 | 1,611 | $38K |
| 2020 | 54 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92015 | 683 | 580 | $18K | |
| 92014 | 513 | 438 | $17K | |
| 92083 | 432 | 334 | $10K | |
| 99214 | 395 | 284 | $9K | |
| 92012 | 383 | 257 | $7K | |
| 92250 | 209 | 161 | $4K | |
| 76513 | 147 | 57 | $4K | |
| V2020 | Vision svcs frames purchases | 189 | 141 | $4K |
| 95930 | 115 | 96 | $4K | |
| 92004 | 87 | 61 | $3K | |
| 92133 | 244 | 190 | $3K | |
| 92286 | 65 | 59 | $3K | |
| 92145 | 520 | 353 | $3K | |
| 92275 | 75 | 63 | $3K | |
| 92273 | 45 | 40 | $2K | |
| 92283 | 126 | 102 | $1K | |
| 68761 | 68 | 12 | $1K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 85 | 40 | $772.20 |
| 92020 | 112 | 82 | $726.75 | |
| 92025 | 65 | 59 | $671.20 | |
| 92340 | 134 | 83 | $392.04 | |
| 99212 | 14 | 12 | $193.20 | |
| 92285 | 19 | 13 | $169.40 | |
| G8427 | Docrev cur meds by elig clin | 18 | 14 | $0.00 |
| 4004F | 144 | 120 | $0.00 | |
| 2027F | 55 | 45 | $0.00 | |
| 3284F | 56 | 46 | $0.00 | |
| 1036F | 129 | 110 | $0.00 |