NPI: 1457757429 · TAHLEQUAH, OK 74464 · 152W00000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 364 | $12K |
| 2019 | 782 | $19K |
| 2020 | 476 | $13K |
| 2021 | 328 | $10K |
| 2022 | 459 | $20K |
| 2023 | 472 | $18K |
| 2024 | 121 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 92014 | 395 | 395 | $43K | |
| 92015 | 1,079 | 1,079 | $19K | |
| 92004 | 105 | 105 | $13K | |
| 92340 | 412 | 412 | $13K | |
| V2020 | Vision svcs frames purchases | 459 | 459 | $5K |
| V2103 | Spherocylindr 4.00d/12-2.00d | 53 | 53 | $1K |
| V2100 | Lens spher single plano 4.00 | 12 | 12 | $334.80 |
| V2784 | Lens polycarb or equal | 487 | 487 | $0.00 |