NPI: 1801339395 · ROWLETT, TX 75088 · Optometrist · NPI assigned 12/01/2016
| Authorized Official | BAUTISTA, DEISY (OPTMETRIST/OWNER) |
| NPI Enumeration Date | 12/01/2016 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 13 | $560.50 |
| 2021 | 95 | $3K |
| 2022 | 106 | $4K |
| 2023 | 28 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| S0620 | Routine ophthalmological examination including refraction; new patient | 156 | 156 | $7K |
| V2025 | Deluxe frame | 41 | 41 | $2K |
| V2100 | Sphere, single vision, plano to plus or minus 4.00, per lens | 15 | 15 | $270.52 |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 30 | 30 | $204.11 |