NPI: 1790338259 · BROKEN ARROW, OK 74012 · Optometrist · NPI assigned 07/23/2019
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 108 | $5K |
| 2022 | 14 | $252.56 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 15 | 15 | $2K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 12 | 12 | $2K |
| 92015 | Determination of refractive state | 50 | 50 | $910.46 |
| 92340 | Fitting of spectacles, except for aphakia; monofocal | 15 | 15 | $450.00 |
| V2020 | Frames, purchases | 15 | 15 | $150.00 |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 15 | 15 | $0.00 |