ST MARIES VISION CENTER, PLLC
NPI: 1780190694
· ST MARIES, ID 83861
· Optometrist
· NPI assigned 12/15/2017
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | FAGAN, LANCE (OWNER) |
| NPI Enumeration Date | 12/15/2017 |
Related Entities
Other providers sharing the same authorized official: FAGAN, LANCE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
26 |
$0.00 |
| 2020 |
15 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
41 |
40 |
$0.00 |