NPI: 1033696877 · TAHLEQUAH, OK 74464 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 1,472 | $44K |
| 2022 | 3,707 | $96K |
| 2023 | 4,026 | $112K |
| 2024 | 3,305 | $95K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 2,240 | 2,186 | $90K | |
| 92004 | 1,628 | 1,606 | $70K | |
| 92015 | 3,950 | 3,856 | $63K | |
| 92340 | 1,941 | 1,868 | $55K | |
| V2025 | Eyeglasses delux frames | 531 | 520 | $16K |
| V2100 | Lens spher single plano 4.00 | 534 | 511 | $15K |
| V2020 | Vision svcs frames purchases | 818 | 782 | $14K |
| S0621 | Routine ophthalmological exa | 203 | 197 | $9K |
| 92012 | 101 | 101 | $5K | |
| V2784 | Lens polycarb or equal | 408 | 381 | $4K |
| S0620 | Routine ophthalmological exa | 67 | 63 | $3K |
| V2200 | Lens spher bifoc plano 4.00d | 30 | 28 | $2K |
| 92341 | 47 | 47 | $1K | |
| 2023F | 12 | 12 | $0.00 |