NATIONAL VISION, INC.

NPI: 1003853383 · WHITEHALL, PA 18052 · Eyewear Supplier · NPI assigned 06/02/2006

$651K

Total Medicaid Paid

22,885

Total Claims

17,529

Beneficiaries

Codes Billed

2019-09

First Month

2023-12

Last Month

Provider Details

Authorized Official	PURCELL, ANNA (PROVIDER NETWORK ADMINISTRATOR)
NPI Enumeration Date	06/02/2006

Other providers sharing the same authorized official: PURCELL, ANNA

Provider	City	State	Total Paid
NATIONAL VISION, INC.	WAIPAHU	HI	$200K
NATIONAL VISION, INC.	SOLDOTNA	AK	$49K
NATIONAL VISION, INC.	LA QUINTA	CA	$35K
NATIONAL VISION, INC.	CORONA	CA	$763.95
NATIONAL VISION, INC.	CHULA VISTA	CA	$0.00
NATIONAL VISION, INC.	OCEANSIDE	CA	$0.00
NATIONAL VISION, INC.	OCEANSIDE	CA	$0.00

Code	Description	Claims	Beneficiaries	Total Paid
92014	Ophthalmological services: medical examination and evaluation, comprehensive, established patient	4,357	4,295	$174K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	5,647	2,890	$173K
V2020	Frames, purchases	5,963	5,222	$123K
92004	Ophthalmological services: medical examination and evaluation, comprehensive, new patient	2,474	2,439	$99K
V2203	Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	744	445	$31K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	588	459	$25K
S0500	Disposable contact lens, per lens	241	239	$16K
S0581	Nonstandard lens (list this code in addition to the basic code for the lens)	71	41	$3K
V2750	Anti-reflective coating, per lens	2,466	1,311	$2K
V2107	Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens	73	42	$2K
V2744	Tint, photochromatic, per lens	240	131	$622.50
V2104	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens	21	15	$594.22