NPI: 1073513081 · JACKSBORO, TN 37757 · Optometrist · NPI assigned 08/01/2005
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 13 | $91.00 |
| 2021 | 60 | $394.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 12 | 12 | $170.00 |
| V2020 | Frames, purchases | 17 | 17 | $160.00 |
| 92015 | Determination of refractive state | 13 | 13 | $91.00 |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 17 | 17 | $64.00 |
| 92250 | 14 | 14 | $0.00 |