NPI: 1245228022 · PUEBLO, CO 81003 · 261QP0905X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 2,871 | $69K |
| 2019 | 4,199 | $79K |
| 2020 | 3,255 | $52K |
| 2021 | 2,956 | $53K |
| 2022 | 4,236 | $73K |
| 2023 | 6,711 | $102K |
| 2024 | 5,240 | $98K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 90460 | 5,853 | 5,724 | $237K | |
| 99212 | 1,177 | 1,049 | $55K | |
| J1050 | Medroxyprogesterone acetate | 1,009 | 967 | $48K |
| 90651 | 1,151 | 1,103 | $21K | |
| 99211 | 1,083 | 936 | $21K | |
| 90471 | 1,035 | 932 | $17K | |
| S4993 | Contraceptive pills for bc | 220 | 196 | $16K |
| 99395 | 164 | 150 | $15K | |
| 99204 | 83 | 74 | $13K | |
| 90472 | 406 | 366 | $9K | |
| 90734 | 1,017 | 958 | $8K | |
| 81025 | 998 | 924 | $8K | |
| 90715 | 1,072 | 1,028 | $7K | |
| 99402 | 122 | 108 | $6K | |
| 99214 | 47 | 44 | $5K | |
| 90710 | 537 | 512 | $5K | |
| 90480 | 111 | 99 | $4K | |
| 99213 | 54 | 54 | $4K | |
| 90688 | 300 | 299 | $4K | |
| 90670 | 574 | 547 | $3K | |
| 99203 | 29 | 29 | $3K | |
| A4267 | Male condom | 3,940 | 3,424 | $2K |
| 90686 | 1,426 | 1,369 | $2K | |
| 91322 | 38 | 32 | $1K | |
| 99000 | 505 | 482 | $1K | |
| 36415 | 503 | 458 | $1K | |
| 90677 | 200 | 179 | $1K | |
| 90656 | 172 | 159 | $927.72 | |
| 90633 | 899 | 862 | $838.80 | |
| 0072A | 14 | 14 | $784.88 | |
| 83655 | 82 | 60 | $778.28 | |
| 90620 | 17 | 14 | $584.30 | |
| 0071A | 15 | 14 | $574.00 | |
| 99459 | 37 | 28 | $567.50 | |
| 90473 | 24 | 24 | $464.76 | |
| 91321 | 23 | 21 | $352.95 | |
| 90696 | 181 | 179 | $340.54 | |
| Q0111 | Wet mounts/ w preparations | 44 | 40 | $234.66 |
| 36416 | 60 | 60 | $190.62 | |
| 86580 | 32 | 25 | $179.83 | |
| 90707 | 12 | 12 | $164.98 | |
| 96372 | 15 | 13 | $147.41 | |
| 90723 | 281 | 272 | $134.90 | |
| 90716 | 13 | 12 | $129.30 | |
| 90647 | 28 | 26 | $88.89 | |
| 90648 | 437 | 423 | $78.82 | |
| 86592 | 512 | 468 | $3.84 | |
| 99072 | 274 | 249 | $0.00 | |
| 90681 | 15 | 12 | $0.00 | |
| 90685 | 15 | 15 | $0.00 | |
| 88175 | 14 | 12 | $0.00 | |
| 90461 | 12 | 12 | $0.00 | |
| 90700 | 24 | 24 | $0.00 | |
| 87390 | 446 | 409 | $0.00 | |
| 99070 | 78 | 61 | $0.00 | |
| 87110 | 1,833 | 1,541 | $0.00 | |
| 86803 | 37 | 33 | $0.00 | |
| 90697 | 34 | 29 | $0.00 | |
| 91307 | 41 | 34 | $0.00 | |
| J0561 | Penicillin g benzathine inj | 93 | 69 | $0.00 |