HILLSIDE OPTOMETRY INC
NPI: 1457060857
· GRANADA HILLS, CA 91344
· Optometrist
· NPI assigned 11/15/2022
$555.23
Total Medicaid Paid
Provider Details
| Authorized Official | KONGSAKUL, ANDY (PRESIDENT) |
| NPI Enumeration Date | 11/15/2022 |
Related Entities
Other providers sharing the same authorized official: KONGSAKUL, ANDY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
30 |
$555.23 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
15 |
15 |
$461.50 |
| 92015 |
Determination of refractive state |
15 |
15 |
$93.73 |