NPI: 1275815359 · DERBY, KS 67037 · Optometrist
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 29 | $799.41 |
| 2023 | 145 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92004 | 17 | 17 | $487.63 | |
| 92014 | 12 | 12 | $311.78 | |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 16 | 15 | $0.00 |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 12 | 12 | $0.00 |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 21 | 12 | $0.00 |
| V2020 | Frames, purchases | 34 | 33 | $0.00 |
| 92015 | 48 | 48 | $0.00 | |
| V2025 | Deluxe frame | 14 | 14 | $0.00 |