NPI: 1487789483 · ARDMORE, OK 73401 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 2,925 | $96K |
| 2019 | 310 | $12K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 402 | 402 | $39K | |
| 92004 | 241 | 241 | $28K | |
| 92340 | 495 | 494 | $15K | |
| 92015 | 687 | 687 | $12K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 343 | 339 | $8K |
| V2020 | Vision svcs frames purchases | 494 | 492 | $5K |
| V2100 | Lens spher single plano 4.00 | 57 | 57 | $1K |
| V2104 | Spherocylindr 4.00d/2.12-4d | 12 | 12 | $279.00 |
| V2784 | Lens polycarb or equal | 504 | 499 | $0.00 |