NPI: 1033568159 · HAVRE, MT 59501 · Optometrist · NPI assigned 06/09/2016
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 132 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2020 | Frames, purchases | 40 | 40 | $646.00 |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 15 | 15 | $644.40 |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 12 | 12 | $240.00 |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 14 | 14 | $175.00 |
| 92015 | Determination of refractive state | 51 | 51 | $0.00 |