NPI: 1467957746 · CASTLE ROCK, CO 80109 · Optometrist · NPI assigned 03/28/2018
| Authorized Official | MOEN, GARRETT (OWNER) |
| NPI Enumeration Date | 03/28/2018 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 75 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2410 | Variable asphericity lens, single vision, full field, glass or plastic, per lens | 12 | 12 | $825.00 |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 12 | 12 | $605.00 |
| V2750 | Anti-reflective coating, per lens | 12 | 12 | $366.24 |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 12 | 12 | $292.27 |
| V2755 | U-v lens, per lens | 12 | 12 | $220.00 |
| 92015 | Determination of refractive state | 15 | 14 | $0.00 |