GLENRIDGE OPTICAL WAREHOUSE OUTLET INC.
NPI: 1982830964
· RIDGEWOOD, NY 11385
· 156FX1800X
$340K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
204 |
$2K |
| 2020 |
251 |
$9K |
| 2021 |
320 |
$12K |
| 2022 |
1,882 |
$78K |
| 2023 |
5,301 |
$178K |
| 2024 |
1,516 |
$60K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
|
2,175 |
2,169 |
$151K |
| 92250 |
|
1,505 |
1,504 |
$71K |
| 92285 |
|
1,440 |
1,439 |
$31K |
| 92060 |
|
659 |
659 |
$24K |
| 92014 |
|
331 |
329 |
$14K |
| 68761 |
|
171 |
85 |
$13K |
| 92015 |
|
886 |
886 |
$9K |
| V2020 |
Vision svcs frames purchases |
889 |
889 |
$7K |
| 92202 |
|
207 |
207 |
$7K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
314 |
226 |
$5K |
| V2100 |
Lens spher single plano 4.00 |
170 |
118 |
$3K |
| 92340 |
|
178 |
177 |
$2K |
| S0580 |
Polycarb lens |
105 |
105 |
$2K |
| V2200 |
Lens spher bifoc plano 4.00d |
57 |
40 |
$1K |
| 92012 |
|
18 |
18 |
$718.00 |
| V2203 |
Lens sphcyl bifocal 4.00d/.1 |
24 |
14 |
$672.06 |
| 92002 |
|
15 |
15 |
$585.00 |
| V2755 |
Uv lens/es |
208 |
104 |
$0.00 |
| V2784 |
Lens polycarb or equal |
122 |
61 |
$0.00 |