NPI: 1013903962 · FORT WAYNE, IN 46804 · Eyewear Supplier · NPI assigned 09/26/2005
| Authorized Official | BRADLEY, JERRY (VICE PRESIDENT) |
| NPI Enumeration Date | 09/26/2005 |
Other providers sharing the same authorized official: BRADLEY, JERRY
| Provider | City | State | Total Paid |
|---|---|---|---|
| JERRY BRADLEY DDS AND ASSOCIATES PLLC | EDENTON | NC | $2.08M |
| TRI-STATE OPTICAL, INC. | FORT WAYNE | IN | $1.22M |
| TRISTATE OPTICAL, INC. | WARSAW | IN | $247K |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 1,700 | $41K |
| 2019 | 1,758 | $55K |
| 2020 | 1,146 | $39K |
| 2021 | 1,119 | $33K |
| 2022 | 656 | $20K |
| 2023 | 61 | $2K |
| 2024 | 141 | $8K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Frames, purchases | 2,512 | 2,310 | $81K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 1,438 | 1,312 | $65K |
| V2755 | U-v lens, per lens | 2,303 | 2,144 | $39K |
| V2730 | Special base curve, glass or plastic, per lens | 243 | 219 | $7K |
| V2203 | Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 72 | 69 | $5K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 13 | 12 | $490.10 |