NPI: 1629797568 · LACKAWANNA, NY 14218 · Optometrist · NPI assigned 08/24/2022
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 116 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Frames, purchases | 40 | 40 | $780.00 |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 12 | 12 | $744.00 |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 15 | 15 | $373.20 |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 28 | 28 | $216.00 |
| 92015 | Determination of refractive state | 21 | 21 | $0.00 |