SUNDANCE OPTICAL CLINIC INC
NPI: 1629786397
· PHOENIX, AZ 85016
· Eyewear Supplier
· NPI assigned 11/10/2022
$441K
Total Medicaid Paid
Provider Details
| Authorized Official | CLARK, PHILIP (OWNER) |
| NPI Enumeration Date | 11/10/2022 |
Related Entities
Other providers sharing the same authorized official: CLARK, PHILIP
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
294 |
$21K |
| 2023 |
2,430 |
$185K |
| 2024 |
2,812 |
$234K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,850 |
1,836 |
$175K |
| V2020 |
Frames, purchases |
1,845 |
1,827 |
$143K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
924 |
913 |
$62K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
809 |
803 |
$54K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
108 |
108 |
$7K |