Bolivar Vision, LLC
Bolivar Vision, LLC was paid $35K by Medicaid between Jul 2018 and Oct 2024, across 11 billing codes. Its largest line is V2020, Frames, purchases — 36% of everything it billed.
33Billing provider infoBOLIVAR VISION, LLC
BOLIVAR, MO 65613
BOLIVAR, MO 65613
33aNPI1578969960assigned 11/12/2014
33bProvider typeOptometrist
28Total paid$35K
24GClaims2,458
24DCodes billed11
24AFirst – last monthJul 2018 – Oct 2024
Compared with peers
Next to other Optometrist providers in Missouri
Rank by total paid#196 of 547
Median peer was paid$19K
This provider vs. median1.9×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 14 | $0.00 | |
| 2019 | 186 | $1K | |
| 2020 | 390 | $5K | |
| 2021 | 741 | $11K | |
| 2022 | 547 | $10K | |
| 2023 | 399 | $7K | |
| 2024incomplete | 181 | $932.68 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| V2020 | Frames, purchases | 36% | 442 | 427 | $13K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 29% | 255 | 234 | $10K |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 15% | 687 | 337 | $5K |
| 92015 | Determination of refractive state | 10% | 790 | 774 | $4K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 9.1% | 69 | 69 | $3K |
| V2103 | Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens | <1% | 46 | 24 | $330.28 |
| 1036F | 0% | 42 | 41 | $0.00 | |
| G8731 | Pain assessment using a standardized tool is documented as negative, no follow-up plan required | 0% | 29 | 28 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 58 | 56 | $0.00 |
| G8785 | Blood pressure reading not documented, reason not given | 0% | 27 | 27 | $0.00 |
| G8783 | Normal blood pressure reading documented, follow-up not required | 0% | 13 | 13 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialMONTGOMERY, LAURA (OPTOMETRIST/OWNER)
| Provider | Location | Paid |
|---|---|---|
| The Center for Individual and Family Services, INC. | Mansfield, OH | $12.05M |
| The Center for Individual & Family Services, INC. | Mansfield, OH | $7.72M |
| Countryside Therapy Group, INC | Stephenville, TX | $3.88M |
| El Dorado Vision LLC | El Dorado Springs, MO | $88K |
| Countryside Therapy Group Home Health, LLC | Stephenville, TX | $8K |
| The Center for Individual & Family Services, INC. | Mansfield, OH | $662.51 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.