NPI: 1174067136 · JOHNS CREEK, GA 30097 · Student in an Organized Health Care Education/Training Program · NPI assigned 12/10/2016
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 66 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 12 | 12 | $360.00 |
| V2020 | Frames, purchases | 14 | 14 | $280.00 |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 14 | 14 | $280.00 |
| 92015 | Determination of refractive state | 14 | 14 | $140.00 |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 12 | 12 | $0.00 |