BUENA VISTA OPTICAL, P.C.
NPI: 1740464296
· CHICAGO, IL 60629
· Eyewear Supplier
· NPI assigned 12/19/2007
$125K
Total Medicaid Paid
Provider Details
| Authorized Official | SIMS, TODD (PRESIDENT) |
| NPI Enumeration Date | 12/19/2007 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
2,722 |
$103K |
| 2019 |
536 |
$23K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,379 |
685 |
$62K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
858 |
551 |
$46K |
| V2025 |
Deluxe frame |
800 |
508 |
$9K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
179 |
179 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
42 |
42 |
$0.00 |