ANDOVER OPTICAL INC
NPI: 1972663383
· ANDOVER, MN 55304
· Contact Lens Technician/Technologist
· NPI assigned 12/08/2006
$331.00
Total Medicaid Paid
Provider Details
| Authorized Official | SANGREN, LAINE (VICE PRES) |
| NPI Enumeration Date | 12/08/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
35 |
$0.00 |
| 2020 |
13 |
$164.32 |
| 2021 |
13 |
$166.68 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
43 |
38 |
$331.00 |
| V2020 |
Frames, purchases |
18 |
14 |
$0.00 |