NPI: 1265971006 · HOLYOKE, CO 80734 · Optometrist · NPI assigned 02/13/2017
| Authorized Official | HASSELL, MICHAEL (CEO) |
| NPI Enumeration Date | 02/13/2017 |
Other providers sharing the same authorized official: HASSELL, MICHAEL
| Provider | City | State | Total Paid |
|---|---|---|---|
| EAST PHILLIPS COUNTY HOSPITAL DISTRICT | HOLYOKE | CO | $37K |
| EAST PHILLIPS COUNTY HOSPITAL DISTRICT | HOLYOKE | CO | $26K |
| EAST PHILLIPS COUNTY HOSPITAL DISTRICT | HOLYOKE | CO | $4K |
| EAST PHILLIPS COUNTY HOSPITAL DISTRICT | HOLYOKE | CO | $2K |
| EAST PHILLIPS COUNTY HOSPITAL DISTRICT | HOLYOKE | CO | $1K |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 240 | $6K |
| 2020 | 45 | $59.40 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 33 | 31 | $3K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 20 | 18 | $846.00 |
| V2020 | Frames, purchases | 20 | 18 | $616.45 |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 18 | 16 | $288.66 |
| V2750 | Anti-reflective coating, per lens | 19 | 17 | $250.11 |
| 92370 | 18 | 16 | $240.38 | |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 15 | 13 | $190.89 |
| 92015 | Determination of refractive state | 142 | 136 | $184.67 |