NPI: 1609005842 · TAHLEQUAH, OK 74464 · 2080A0000X
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 10,301 | $480K |
| 2019 | 7,707 | $392K |
| 2020 | 5,488 | $290K |
| 2021 | 4,683 | $253K |
| 2022 | 5,165 | $289K |
| 2023 | 3,971 | $241K |
| 2024 | 1,107 | $66K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99213 | 19,377 | 15,154 | $1.36M | |
| 99214 | 1,809 | 1,664 | $170K | |
| 87880 | 6,670 | 6,171 | $96K | |
| 99392 | 605 | 600 | $55K | |
| 99393 | 593 | 592 | $54K | |
| 90471 | 2,848 | 2,821 | $51K | |
| 99394 | 476 | 475 | $48K | |
| 99391 | 498 | 494 | $43K | |
| 90472 | 1,525 | 1,518 | $42K | |
| 87804 | 1,617 | 1,513 | $38K | |
| 99203 | 243 | 243 | $22K | |
| 99212 | 421 | 395 | $15K | |
| 87426 | 194 | 181 | $9K | |
| 99204 | 24 | 24 | $3K | |
| 99211 | 170 | 161 | $3K | |
| 90474 | 66 | 66 | $1K | |
| 87807 | 89 | 86 | $1K | |
| 83655 | 53 | 53 | $657.08 | |
| 96127 | 161 | 161 | $656.54 | |
| 96372 | 19 | 14 | $386.84 | |
| 83036 | 12 | 12 | $118.32 | |
| J0696 | Ceftriaxone sodium injection | 23 | 14 | $48.51 |
| 85018 | 15 | 15 | $36.15 | |
| 90688 | 433 | 433 | $19.19 | |
| 90734 | 51 | 51 | $0.00 | |
| 90670 | 75 | 75 | $0.00 | |
| 90633 | 14 | 14 | $0.00 | |
| 96160 | 315 | 315 | $0.00 | |
| 90715 | 14 | 14 | $0.00 | |
| 90680 | 12 | 12 | $0.00 |