Center for Ocular Prosthetics
Custom Made Artificial Plastic Eyes
Covered by Most Insurances and Medicare! Pre-Authorization Available
Formerly of Mager & Gougelmann, Inc.
Request Insurance Authorization:  
Full Name:
And, if applicable, the Primary Member
  
Home Address:
City:
State:
Zip:
Main Phone:
Other Phone:
Email:
Date of Birth:
and, if applicable the Primary Member date of birth
Insurance 
Company:
Insurance Co. 
Phone Number:
Your ID#

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Insurance Companies

Most insurance companies will pay a portion or all of the fee depending on your coverage. If you would like us to check with your insurance company for your benefit/eligibility for a prosthesis and request a preauthorization, please fill out the form opposite.
Phone Numbers

Also, provide us with an alternative phone number to reach you, if we have any additional questions, or to get in touch with you once we receive approval.

Our direct number is
1-888-770-6049.
Email

Our email address
susanapeters@aol.com