NPI: 1699818864 · WYNNEWOOD, OK 73098 · Optometrist · NPI assigned 02/15/2007
| Authorized Official | BRAGG, EVAN (SR MANAGER) |
| NPI Enumeration Date | 02/15/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 101 | $3K |
| 2020 | 77 | $4K |
| 2021 | 68 | $2K |
| 2022 | 38 | $3K |
| 2023 | 97 | $3K |
| 2024 | 62 | $2K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 114 | 114 | $12K |
| 92015 | Determination of refractive state | 123 | 123 | $2K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 60 | 60 | $2K |
| V2020 | Frames, purchases | 70 | 70 | $700.00 |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 17 | 17 | $504.56 |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 59 | 59 | $0.00 |