NPI: 1255415188 · WICHITA FALLS, TX 76301 · 261QP0905X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 29 | $67.44 |
| 2019 | 43 | $203.84 |
| 2020 | 200 | $1K |
| 2021 | 971 | $6K |
| 2022 | 1,432 | $6K |
| 2023 | 1,115 | $9K |
| 2024 | 1,075 | $7K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 90471 | 1,691 | 1,612 | $14K | |
| 90472 | 1,397 | 793 | $11K | |
| 90619 | 269 | 258 | $1K | |
| 90715 | 398 | 371 | $866.38 | |
| 86580 | 180 | 167 | $623.06 | |
| 90734 | 103 | 102 | $362.00 | |
| 90716 | 15 | 15 | $162.01 | |
| 90688 | 20 | 20 | $152.52 | |
| 90707 | 28 | 28 | $96.11 | |
| 90633 | 186 | 176 | $0.00 | |
| 90713 | 101 | 95 | $0.00 | |
| 90710 | 147 | 139 | $0.00 | |
| 90700 | 123 | 114 | $0.00 | |
| 90696 | 53 | 50 | $0.00 | |
| 90651 | 125 | 117 | $0.00 | |
| 90686 | 14 | 14 | $0.00 | |
| G0008 | Admin influenza virus vac | 15 | 13 | $0.00 |