NPI: 1366410862 · FAIRMONT, MN 56031 · 261QM1300X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 19,728 | $231K |
| 2019 | 21,702 | $885K |
| 2020 | 17,566 | $749K |
| 2021 | 31,375 | $978K |
| 2022 | 24,371 | $803K |
| 2023 | 17,015 | $622K |
| 2024 | 12,659 | $446K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99214 | 28,480 | 25,510 | $1.42M | |
| 99284 | 10,791 | 9,857 | $749K | |
| 99213 | 21,553 | 19,283 | $684K | |
| 99285 | 3,340 | 3,039 | $338K | |
| 99215 | Prolong outpt/office vis | 3,222 | 3,015 | $239K |
| 99283 | 6,422 | 5,938 | $232K | |
| 99309 | 1,411 | 1,005 | $94K | |
| 92014 | 1,608 | 1,585 | $79K | |
| 99392 | 1,381 | 1,371 | $71K | |
| V2020 | Vision svcs frames purchases | 1,957 | 1,832 | $61K |
| S0302 | Completed epsdt | 1,434 | 1,420 | $55K |
| 99212 | 2,786 | 2,584 | $55K | |
| 99203 | 1,274 | 1,220 | $54K | |
| 99391 | 1,156 | 1,125 | $47K | |
| 92340 | 1,940 | 1,832 | $44K | |
| 99310 | Prolong nursin fac eval 15m | 462 | 345 | $44K |
| 92004 | 710 | 696 | $42K | |
| 92015 | 3,224 | 3,155 | $38K | |
| V2103 | Spherocylindr 4.00d/12-2.00d | 1,232 | 741 | $36K |
| 99308 | 797 | 522 | $33K | |
| X5622 | 1,099 | 1,033 | $33K | |
| V2784 | Lens polycarb or equal | 3,015 | 1,550 | $31K |
| 74177 | 544 | 524 | $31K | |
| 99393 | 541 | 536 | $31K | |
| 93010 | 5,858 | 4,907 | $27K | |
| 99202 | 634 | 604 | $21K | |
| 99394 | 336 | 335 | $20K | |
| 71046 | 2,242 | 2,068 | $13K | |
| 99395 | 140 | 139 | $10K | |
| 99396 | 121 | 120 | $9K | |
| 99188 | 568 | 562 | $8K | |
| 70450 | 277 | 257 | $8K | |
| 96110 | 931 | 921 | $7K | |
| G2211 | Complex e/m visit add on | 1,503 | 1,433 | $6K |
| 92341 | 169 | 168 | $5K | |
| 90837 | 43 | 42 | $5K | |
| 99232 | 147 | 43 | $5K | |
| 98927 | 171 | 150 | $4K | |
| 71045 | 598 | 537 | $4K | |
| 77067 | 188 | 186 | $4K | |
| 99239 | 29 | 27 | $2K | |
| 99291 | 12 | 12 | $2K | |
| 99442 | 70 | 61 | $2K | |
| 99443 | 42 | 39 | $2K | |
| 90832 | 350 | 259 | $1K | |
| 36415 | 354 | 302 | $1K | |
| 87651 | 48 | 44 | $1K | |
| 92551 | 113 | 113 | $966.00 | |
| 73630 | 169 | 141 | $864.95 | |
| 71275 | 13 | 13 | $717.47 | |
| G2212 | Prolong outpt/office vis | 25 | 24 | $613.64 |
| 99173 | 320 | 320 | $601.73 | |
| V2104 | Spherocylindr 4.00d/2.12-4d | 16 | 12 | $543.58 |
| 99307 | 17 | 12 | $535.74 | |
| 77063 | 38 | 38 | $492.49 | |
| 0764T | 30 | 25 | $460.88 | |
| 96161 | 148 | 146 | $338.95 | |
| 73564 | 30 | 25 | $250.52 | |
| 87880 | 183 | 176 | $181.89 | |
| 99211 | 13 | 12 | $33.97 | |
| 3074F | 8,836 | 7,779 | $0.00 | |
| G9717 | Doc pt dx bipol | 4,591 | 3,307 | $0.00 |
| G8510 | Scr dep neg, no plan reqd | 488 | 481 | $0.00 |
| 3079F | 2,586 | 2,346 | $0.00 | |
| 3075F | 1,104 | 1,039 | $0.00 | |
| 3080F | 395 | 361 | $0.00 | |
| 3044F | 517 | 391 | $0.00 | |
| G8432 | Dep scr not doc, rng | 221 | 188 | $0.00 |
| 1123F | 238 | 170 | $0.00 | |
| 1111F | 72 | 58 | $0.00 | |
| 3078F | 7,214 | 6,389 | $0.00 | |
| 0502F | 915 | 600 | $0.00 | |
| G1004 | Cdsm ndsc | 213 | 153 | $0.00 |
| 1159F | 27 | 24 | $0.00 | |
| 3077F | 612 | 550 | $0.00 | |
| 73610 | 13 | 12 | $0.00 | |
| 85610 | 33 | 12 | $0.00 | |
| 99358 | Prolong nursin fac eval 15m | 16 | 12 | $0.00 |