NPI: 1053465096 · NIOBRARA, NE 68760 · 261Q00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 4,002 | $873K |
| 2019 | 4,392 | $975K |
| 2020 | 4,122 | $973K |
| 2021 | 6,120 | $1.64M |
| 2022 | 6,566 | $2.30M |
| 2023 | 6,038 | $2.17M |
| 2024 | 4,251 | $1.69M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T1015 | Clinic service | 19,177 | 15,508 | $10.33M |
| 99213 | 7,742 | 6,909 | $120K | |
| 99212 | 4,649 | 4,153 | $108K | |
| 87635 | 826 | 780 | $36K | |
| 87430 | 135 | 134 | $15K | |
| 92340 | 131 | 130 | $6K | |
| V2020 | Vision svcs frames purchases | 162 | 161 | $4K |
| 99214 | 60 | 27 | $197.42 | |
| 96372 | 31 | 27 | $9.50 | |
| 90471 | 132 | 131 | $5.80 | |
| D1206 | 802 | 638 | $0.00 | |
| 90834 | 126 | 80 | $0.00 | |
| D0120 | 109 | 109 | $0.00 | |
| 0011A | 13 | 13 | $0.00 | |
| D0140 | 31 | 24 | $0.00 | |
| T1014 | Telehealth transmit, per min | 51 | 48 | $0.00 |
| 0144A | 34 | 34 | $0.00 | |
| 91301 | 223 | 222 | $0.00 | |
| Q3014 | Telehealth facility fee | 51 | 48 | $0.00 |
| 0012A | 24 | 24 | $0.00 | |
| 91314 | 34 | 34 | $0.00 | |
| 0134A | 22 | 22 | $0.00 | |
| 90686 | 39 | 39 | $0.00 | |
| 92014 | 121 | 119 | $0.00 | |
| D1120 | 363 | 294 | $0.00 | |
| 3210F | 211 | 210 | $0.00 | |
| 92015 | 139 | 137 | $0.00 | |
| 0013A | 19 | 19 | $0.00 | |
| 91313 | 22 | 22 | $0.00 | |
| 87400 | 12 | 12 | $0.00 |