NPI: 1447950183 · ROLLA, MO 65401 · Optometrist · NPI assigned 03/09/2023
| Authorized Official | GARDNER, KEVIN (OWNER) |
| NPI Enumeration Date | 03/09/2023 |
Other providers sharing the same authorized official: GARDNER, KEVIN
| Provider | City | State | Total Paid |
|---|---|---|---|
| GRACIE CHASE AVERY, LLC | JOPLIN | MO | $1.06M |
| PIPER'S VISION XPRESS, LLC | MOUNTIAN HOME | AR | $44K |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 411 | $14K |
| 2024 | 1,374 | $53K |
| Code | Description | Claims | Bene. Records | Total Paid |
|---|---|---|---|---|
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 640 | 630 | $55K |
| V2020 | Frames, purchases | 102 | 98 | $5K |
| 92015 | Determination of refractive state | 644 | 634 | $2K |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 292 | 290 | $2K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | 65 | 35 | $2K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 30 | 15 | $900.00 |
| 92341 | 12 | 12 | $60.00 |