WESTERN OPTICAL OUTLET, INC
NPI: 1083613988
· HORMIGUEROS, PR 00660
· Optometrist
· NPI assigned 07/21/2005
$370.00
Total Medicaid Paid
Provider Details
| Authorized Official | COLON, LIZA (PRESIDENT) |
| NPI Enumeration Date | 07/21/2005 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
47 |
$370.00 |
| 2019 |
174 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
76 |
60 |
$370.00 |
| V2020 |
Frames, purchases |
59 |
43 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
19 |
13 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
42 |
13 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
25 |
15 |
$0.00 |